From Deflated to Elevated: Breast Lift, Augment, or Both?

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In this educational and empowering episode, board-certified plastic surgeons Dr. Sam Fuller and Dr. Daniel Butz dive into one of the most common questions they hear from patients: "Do I need a breast lift, a breast augmentation, or both?" If you've ever stood in front of the mirror wondering how to restore volume, perkiness, or shape to your breasts, this episode is tailor-made for you.

We break down the anatomy and aesthetic principles that guide our surgical decisions, helping patients better understand what each procedure is designed to accomplish. A breast augmentation and a breast lift are not interchangeable—and understanding the core difference is essential to getting the results you want.

We begin by walking through breast anatomy and the natural aging process, including how pregnancy, weight changes, gravity, and genetics affect skin elasticity and glandular volume. This leads into a deep discussion on the goals of breast augmentation—adding volume, fullness, and upper pole projection—versus the goals of a breast lift, which include reshaping, repositioning the nipple-areolar complex, and removing excess skin to restore a youthful contour.

Next, we dive into how we evaluate patients during consultation:

• Is the nipple below the inframammary fold?
• Is there volume loss or deflation?
• Is the breast tissue dense or soft?
• Are the patient’s goals focused on size, shape, lift, or all of the above?

We’ll talk through real-world examples and how we tailor recommendations based on body type, age, future plans (like pregnancy or weight loss), and surgical risk tolerance.

Dr. Butz and Dr. Fuller also weigh the pros and cons of each surgery, including:

• Scarring and incision types
• Recovery time
• Longevity of results
• Implant risks (rupture, capsular contracture)
• Lift-only limitations (no added volume or upper pole fill)
• When it’s best to combine both procedures for maximum impact

We also touch on common misconceptions—like the myth that implants alone can lift a sagging breast, or the idea that a lift always results in a “flattened” look without implants. Spoiler alert: it’s all about planning and technique.

If you’ve ever felt overwhelmed by the idea of choosing between a lift and an augmentation, this episode will leave you feeling educated, reassured, and empowered to take the next step. You’ll walk away with practical knowledge and a better understanding of how we, as plastic surgeons, customize surgical plans to help each patient achieve their unique goals.

Whether you're postpartum, post-weight loss, or just looking to restore confidence, this episode will help you understand what’s possible—and what’s right for you.

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