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Breast Augmentation with Lift

Breast Augmentation with Lift in San Francisco, CA

Women often experience drooping breasts and a lack of volume simultaneously, which cannot always be addressed with one breast enhancement procedure alone. When this is the case, combining multiple techniques is often the best way to reach your desired result.

Dr. Leonard Gray is a master plastic surgeon who maintains expertise in many aesthetic breast procedures, such as breast augmentation, breast lift, and breast reduction. When patients want to combine the benefits of breast augmentation and a breast lift, Dr. Gray often recommends a procedure called a breast augmentation with lift.

To learn more about breast augmentation with lift in San Francisco, CA, we invite you to continue reading or contact Bay Area Plastic Surgery today!

What is a Breast Augmentation and Lift?

woman poses showing upper body

As the name implies, breast augmentation and lift is the combination of two procedures: breast augmentation and breast lift.

Combining a breast lift with implants is a good way to get the most from your surgery. With this procedure, your breasts will increase in cup size but also look better than with just one procedure.

Why Would I Consider a Bay Area Breast Augmentation with Lift?

Breast augmentation with a lift is often desired by women who want to receive the benefits of a breast lift while adding more fullness to the upper breast. 

There are two general ways to provide fullness to this area:

  • Breast implant- Adding a breast implant to your breast lift can add sufficient volume to the upper portion of the breast. As with a standard breast augmentation, you can choose your breast implant size when you meet with Dr. Gray in a consultation. This method is recommended for women who do not mind adding some volume to the breasts.
  • Tissue transposition- In this method, Dr. Gray relocates sections of tissue from the lower section of the breast into the upper portion. While this method will suffice for a specific set of patients, it provides a modest fullness that is often not enough for those looking to go bigger. This operation is typically better suited for those who want some fullness without adding significant volume.

How is a Breast Lift with Augmentation Performed?

Breast augmentation with lift is an outpatient procedure performed under general anesthesia in Bay Area Plastic Surgery’s AAAASF accredited surgical center. Prior to your surgery, Dr. Gray will administer a nerve block. Patients can choose from a nerve block that lasts six to eight hours or Exparel®, a numbing solution that will last for up to four days. Exparel is ideal for patients who wish to work from home during recovery, do not wish to be sore, have responsibilities like looking after small children, want to avoid narcotic medications, or have other similar concerns.

For the majority of breast augmentation with lift operations, Dr. Gray uses a vertical breast lift technique. The vertical lift begins with relaxing the muscles within the chest, which allows the implant to settle when inserted. Dr. Gray then carefully removes skin from around the areola to resize it and lift it to a higher position. A small incision is then made in the bottom portion of the breast, between the breast fold and the lower edge of the areola, to create the breast implant pocket and insert the implants beneath the muscle. The implant incision is then closed at a deeper layer.

Following this, a section of breast tissue in the lower pole of the breast is excised. In many vertical breast lifts, this tissue would be added to the upper breast, but this is not needed when an implant is inserted. The breast tissue called “pillars” are then sewn to one another. This gives internal support that is long-lasting, like an internal bra.

What are the Advantages of the Vertical Lift?

Several techniques for breast augmentation with lift are popular, including the inferior pedicle and vertical lifts. The vertical lift allows for the longest lasting results with the least amount of visible scarring, which is why it is most often the method of choice for Dr. Gray.

Furthermore, this lift:

  • Provides internal support of the breast with less risk of drooping or “bottoming out” in the postoperative period.
  • Produces a more conical-shaped breast. Other lift techniques can make the breast appear flat and have more of a “pancake” look. Vertical lifts look more like an ideal breast in terms of shape.
  • Prevents significant scarring beneath the breast. The vertical lift has only a fine line scar around the areola and down the breast in a vertical direction. Your scar should be even flatter and smaller by using Biocorneum™, a silicone scar reducing ointment from Sientra®. Using this for a year can drastically reduce the appearance of scarring.

Dr. Gray can also perform other breast lift techniques that he may recommend for you, which you can learn more about by visiting our breast lift page.

What Can I Expect in a Breast Augmentation with Lift Recovery?

Each patient’s recovery timeline will differ based on the methods employed in their surgery and their ability to heal. Many patients are ready to return to non-strenuous work after a week, but they should refrain from their full daily activities for 2 or 3 weeks. Furthermore, Dr. Gray advises that patients use caution for the first 6-8 weeks after a breast lift with augmentation because of the many suture lines that need to heal. Keeping your activity levels low during this period is crucial to healing safely and correctly. Dr. Gray’s standard recommendation is to exercise only by flat walking and holding no more than a Starbucks cup until the 6-8-week mark is reached.

You will be given two bras: one for the first week after surgery, and then a French bra that you wear day and night for the next two months. You can switch back to your regular bra routine after this period. 

Stunning natural results

Dr. Gray’s training, precision, and personalized treatment plans provide genuinely outstanding results. Want to see for yourself? Follow the link below to view before and after pictures of Dr. Gray’s actual patients.

Ready to Learn More?

If you want to learn more about this procedure, our team invites you to meet with Dr. Leonard Gray in a one-on-one consultation. Here, you can ask questions and learn more about each of the procedures you are interested in. Dr. Gray believes in educating his patients to make informed decisions of their own accord.

To get started, contact Bay Area Plastic Surgery by filling out our online form or calling (415) 434-8858 today.

Breast Augmentation with Lift FAQS

Most women who choose breast augmentation with lift opt for moderate or low profile implants, which are smaller, flatter, and more conservative. The patients are looking for fullness, but they don’t want breasts to be too big.

Breast lifts can last for years, especially when patients adhere to a healthy lifestyle. Any significant weight gain or additional pregnancies could compromise the results of the surgery. This is why it is recommended to have this type of surgery when the patient is at or near their goal weight, and does not plan to become pregnant in the future. As for breast implants, while they may not last a lifetime, they are manufactured to last up to 15 years or longer.

Due to the nature of the procedure, scarring is unavoidable. The incisions made during a breast lift are patterned to best meet the aesthetic goals of the patient. Although these incisions can be concealed under clothing, they will still exist. The good news, is that over time and with proper scar care, they do fade and become barely noticeable. Most women find that their new shape and beautiful figure outweigh the scarring.

There are many implants to choose from. Dr. Gray offers implants from three different manufacturers with four different projections and a number of widths. You can learn more about the different breast implant types by visiting our breast augmentation page or scheduling a consultation with Dr. Gray.

If you are receiving a vertical lift, your scar will be around your nipple in a circle, and from the bottom of the areola towards the bottom of the breast. Dr. Gray will explain your other options when you meet with him in a consultation.

When you add an implant via a vertical lift, your size will be slightly smaller (about a cup size) than it appears when sizing in the office. This is to account for tissue being removed during the surgery. Dr. Grey has performed countless procedures and will help you find the perfect size.  

Breast augmentation with a breast lift is typically considered when there are two main concerns: the need for increased volume (size) and significant ptosis (sagging) of the breasts.

  • Increased Volume: Breast augmentation involves the placement of implants to enhance the size and fullness of the breasts. If a patient desires larger breasts or wants to restore lost volume due to factors like pregnancy, weight loss, or aging, breast augmentation can help achieve this.
  • Significant Ptosis: Ptosis refers to the degree of sagging in the breasts. When there’s noticeable sagging, a breast lift (mastopexy) is performed to elevate and reshape the breasts. This procedure involves removing excess skin, repositioning the nipple-areolar complex, and reshaping the breast tissue to achieve a more youthful and lifted appearance.

When both of these concerns are present, combining breast augmentation with a breast lift can provide comprehensive results. The augmentation addresses volume enhancement, while the lift addresses sagging and restores a more youthful contour. This combined approach can yield a balanced and harmonious outcome, addressing both size and shape concerns in one surgery.

There are three common types of breast lifts, each designed to address varying degrees of ptosis (sagging) and achieve different outcomes:

Vertical Breast Lift : This is my preferred breast lift procedure. The vertical breast lift is often chosen when there is moderate to severe sagging. The incisions are made around the perimeter of the areola and then extend vertically down close to the inframammary fold. This technique allows me to reshape the breast tissue, reposition the nipple-areolar complex higher on the breast mound, and remove excess skin. The resulting scar resembles a lollipop shape, with one incision around the areola and another running down the breast. Lower pole breast tissue is sutured to itself to provide internal support like an internal bra.

Inferior Pedicle Breast Lift (Anchor Lift): The inferior pedicle breast lift is employed for breasts with substantial sagging. It involves three incisions: one around the areola, a vertical incision from the bottom of the areola to the inframammary fold, and a horizontal incision along the inframammary fold. This technique provides greater access to lift and reshape the breast tissue, reposition the nipple, and remove excess skin. The resulting scar resembles an anchor shape, incorporating the incisions around the areola, vertically down the breast, and horizontally along the fold.

Benelli Breast Lift (Donut Lift): The Benelli breast lift is suitable for mild to moderate sagging and is often performed in conjunction with breast augmentation. A circular incision is made around the areola, allowing me to adjust the position of the areola and reshape the breast tissue. This technique is less invasive than the vertical or anchor lifts and results in a scar that circles the areola.

Advantages of Vertical Breast Lift:

  • Less Scarring: One of the key advantages of the vertical breast lift, also known as the lollipop lift, is that it results in less scarring compared to the anchor lift (inferior pedicle breast lift). The vertical incision extends down from the areola to the inframammary fold, creating a lollipop shape. This means there is no horizontal incision along the inframammary fold, reducing the overall length of scars.
  • Internal Support: During a vertical breast lift, I sew the lower pole breast tissue to itself, creating an internal support structure. This technique helps prevent excessive bottoming out, which is when the breast tissue settles too low on the chest wall. The internal support provided by this technique helps maintain a more lifted and youthful shape over time.
  • Improved Breast Shape: The vertical breast lift allows me to reshape the breast tissue more effectively. By removing excess skin and sewing the breast tissue together, the procedure can result in improved projection, symmetry, and overall breast contour.

Advantages of Inferior Pedicle Breast Lift (Anchor Lift) in the Bay Area:

  • Addressing Severe Sagging: The anchor lift (inferior pedicle breast lift) is particularly effective for breasts with significant sagging or ptosis. The extensive incisions and access provided by this technique allow the board-certified plastic surgeon to remove a larger amount of excess skin and reshape the breast tissue more comprehensively.
  • Customizable Reshaping: The anchor lift offers a high level of control over reshaping the breasts. This technique is suitable for cases where significant lifting, reshaping, and repositioning of the nipple-areolar complex are required to achieve desired results.

It’s important to note that the choice between a vertical breast lift and an inferior pedicle breast lift depends on individual factors such as the degree of sagging, breast size, tissue quality, and the patient’s goals.

Absolutely. You can get a breast lift without using breast implants. The decision to use implants or not depends on the patient’s goals and individual circumstances.

Bay Area Breast Lift without Implants:

A breast lift without implants involves reshaping and repositioning the existing breast tissue to achieve a more lifted and youthful appearance. This procedure is suitable for individuals who are primarily concerned about sagging and wish to restore the natural shape and contour of their breasts without adding additional volume through implants.

Vertical Breast Lift:

The vertical breast lift is particularly well-suited for achieving a lifted appearance without implants. During this procedure, your Bay Area board-certified plastic surgeon removes excess skin, repositions the nipple-areolar complex, and reshapes the breast tissue. Additionally, the lower pole breast tissue is transposed superiorly, which can create some upper pole fullness. This means that the tissue from the lower part of the breast is moved upwards to give the appearance of increased volume in the upper portion of the breast.

Inferior Pedicle Breast Lift (Anchor Lift):

Unlike the vertical breast lift, the inferior pedicle breast lift (anchor lift) doesn’t involve transposing lower pole breast tissue superiorly to create upper pole fullness. This technique is more focused on addressing significant sagging and reshaping the breast tissue. The primary aim of the anchor lift is to achieve a lifted position of the breasts and reposition the nipple-areolar complex to a more youthful location.

Scarring for Vertical Breast Lift:

The scarring for a vertical breast lift is typically around the areola and extends vertically down to the inframammary fold. This results in a lollipop-shaped scar. The vertical incision tends to heal well, and over time, the scar often becomes less noticeable.

Scarring for Inferior Pedicle Breast Lift (Anchor Lift):

With an inferior pedicle breast lift, the scarring is more extensive. It includes an incision around the areola, a vertical incision down to the inframammary fold, and a horizontal incision along the fold. This creates an anchor-shaped scar. While the scarring is more significant compared to a vertical lift, it’s important to note that these scars are placed in areas that can be concealed by clothing and undergarments.

Scarring for Benelli Breast Lift (Donut Lift):

For a Benelli breast lift, the scarring is limited to an incision around the edge of the areola. This circular scar is less extensive than the scars associated with vertical or anchor lifts.

Areola Reduction (Benelli Breast Lift):

Areola reduction, also known as the Benelli breast lift or donut lift, is a surgical procedure that focuses on resizing and repositioning the areola to achieve a more proportionate and youthful appearance. This procedure is often combined with an incision around the edge of the areola, which allows for adjustments to the position of the nipple-areolar complex and the surrounding breast tissue.

Candidacy for Areola Reduction:

Candidates for areola reduction are typically individuals who have mild ptosis (sagging) of the breasts and desire a more lifted and youthful appearance. This procedure is particularly useful for individuals with large areolas, as it can help achieve better proportions between the areola and the breast mound. The incision for areola reduction is around the areola itself, resulting in a circular scar.

Limitations of Areola Reduction:

While areola reduction can be effective for addressing mild ptosis and large areolas, it’s important to note that it may not provide sufficient lifting and reshaping for individuals with more significant sagging. In cases of moderate to severe ptosis, where greater lifting and reshaping are required, a vertical breast lift or an inferior pedicle breast lift might be more appropriate. These procedures involve more extensive incisions and allow for greater repositioning of the breast tissue.

Minimizing Scars After Breast Lift Surgery:

  • Silicone Application: Silicone is known for its ability to help reduce scar visibility. Silicone sheets or ointments can be applied to the incision site after the surgical wound has healed. All of my surgery patients receive a bottle of Biocorneum ointment at their follow-up visit. This is a silicone-based product that is applied directly over healed scars to help reduce their appearance. Patients use this product 1-2 times per day for about 1 year.
  • Microneedling Radiofrequency (RF) Device: Microneedling RF devices, such as the Potenza, can be effective in treating scars and improving their appearance. These devices combine microneedling, which creates controlled micro-injuries in the skin, with radiofrequency energy, which heats the deeper layers of the skin to stimulate collagen production and promote skin tightening. This combination can help improve scar texture, pigmentation, and overall appearance.

Benefits of Microneedling RF for Scar Treatment:

  • Skin Tightening: Microneedling RF promotes collagen and elastin production, leading to improved skin elasticity and tightness. This can help reduce the appearance of scars and provide a smoother skin surface.
  • Scar Resurfacing: The micro-injuries created by microneedling promote skin renewal and resurfacing. Over time, this can help reduce scar texture irregularities and make the scar tissue blend more seamlessly with the surrounding skin.
  • Scar Pigmentation: Microneedling RF can also address scar pigmentation issues, such as hyperpigmentation or hypopigmentation, by promoting more even skin tone.

It’s important to note that while these methods can help minimize scars, complete scar elimination is not always possible. Individual healing varies, and factors such as genetics, skin type, and scar location can influence the outcome.

Potential Need for Another Breast Lift:

While a breast lift can provide significant improvement in breast shape and position, it’s important to understand that the effects of gravity and the natural aging process continue to affect the breasts over time. While not everyone will need another breast lift in the future, some factors can contribute to the potential need for additional surgery:

  • Aging and Gravity: Over time, the effects of gravity, aging, and skin elasticity can cause the breasts to naturally sag again, albeit at a slower rate than before the initial lift.
  • Weight Changes: Significant weight fluctuations, pregnancy, and breastfeeding can impact the breast tissue’s elasticity and contribute to sagging, potentially requiring a revision surgery.
  • Genetics: Genetic factors play a role in how the body ages and how the skin and tissues respond to various changes. Some individuals may be more prone to sagging due to their genetic makeup.

Longevity of Results:

The longevity of the results from a breast lift varies from person to person. While some individuals may enjoy the benefits of a breast lift for many years, others might experience more significant changes over time. Maintaining a healthy lifestyle, avoiding significant weight fluctuations, and wearing supportive bras can help prolong the results of a breast lift.

Nipple Sensation:

Potential Impact on Nipple Sensation: Nipple sensation can be affected by breast lift surgery, but it’s not a common occurrence. The degree of sensory change can vary from person to person and is influenced by factors such as the surgical technique used, the extent of the lift, and individual variations in nerve sensitivity.

Temporary Changes: Some patients may experience temporary changes in nipple sensation immediately after surgery, including numbness or heightened sensitivity. These changes often resolve as the body heals and nerves regenerate.

Permanent Changes: In very rare cases, permanent changes in nipple sensation can occur after a breast lift. Nerves that provide sensation to the nipple-areolar complex may be disrupted during the surgery, leading to altered sensation.


Potential Impact on Breastfeeding: Breast lift surgery, when performed without altering the nipple-areolar complex, generally has a lower likelihood of affecting breastfeeding. However, it’s important to note that breastfeeding can still be influenced by various factors, including the individual’s breast anatomy and breastfeeding ability prior to surgery.