Breast augmentation is without question among the most frequently performed plastic surgery procedures. Many women have already undergone it, many others are preparing for it, and everybody is discussing this topic online. What some women still don’t understand is that breast augmentation is not a one-size-fits-all solution for all problems related to the appearance of the breasts. When it comes to breast reduction, things are pretty clear: the procedure is used to reduce the volume of overly large breasts. But when it comes to breast augmentation, people believe they can use implants to correct any type of breast imperfection, including sagginess. Is this possible? In this article, we will discuss and try to understand the difference between breast augmentation and breast lift. For plastic surgery on the breasts, we have three main types: breast reductions, breast augmentations, and breast lifts. Breast reduction The procedure is performed on women with heavy breasts who experience difficulties in day-to-day life because of the excessive weight of the breasts. Conditions that are commonly associated with overly large breasts are difficulty in breathing, back, neck and shoulder pain, bad body posture, as well as emotional discomfort. The procedure aims to reduce the size of the breasts by removing a part of the mammary gland along with the skin and fat tissues. Breast augmentation The procedure on the opposite side of breast reduction is breast augmentation. It is performed to increase the volume of the breasts, and there are multiple options to this: implants or fat transfer. A large portion of women in the United States have breasts on the smaller side. Some of these women want to make their body more feminine by getting an augmentation with the help of plastic surgery. When an augmentation is performed, the plastic surgeon will insert silicone or saline implants inside the breasts, either behind the mammary gland or the pectoral muscle. Fat transfer can also be used to add volume to breasts. When this procedure is chosen, the surgery will start with liposuction on the donor areas. From here the plastic surgeon will collect the fat that will go through a complex purification process. It is only the healthy fat cells that will be reinjected into the breasts to increase their volume. The results achieved with implants can’t be compared with the ones of a fat transfer, especially in terms of projection. However, the two methods for breast augmentation can be performed in tandem for superior aesthetic results. Breast lift After one or multiple pregnancies, as well as considerable fluctuations or aging, the breasts might start to fall on the chest wall. The condition is called breast ptosis in medical terms, and it is known to affect all women sooner or later in their lives, depending on the size of the breasts and their genetic predispositions. This means that even if your breasts have been perfect since you were a teenager, there will come a time when your nipple will start facing downward and a vast part of your mammary tissue will be situated under the inframammary fold. A breast lift can correct mammary ptosis and elevate the breasts higher on the chest wall by re-centering the mammary tissues. During the procedure, the excess skin and fat tissues will also be removed. Initial consultation for breast surgery This is the first contact with the plastic surgeon, during which the patient’s request is assessed and examined to see if it is justified. The patient’s psychological condition is also assessed to determine if the patient will be able to cope with the long-term consequences of the procedure. Even if the surgery is a success, the patient still needs some time to adjust to the new look of her body. Tests are also conducted and the family medical history is checked for breast cancer. The patient will be asked to take a pregnancy test and blood tests as well. The patient’s request is also studied during this meeting. We then examine, more technically, what to do and what technique to use. If it is a breast reduction, the amount of mammary gland to be removed is evaluated. The plastic surgeon explains the scars that will result from the surgery, preferably with photos and various examples to support it. If the request is for a breast augmentation, the surgeon will perform more measurements before recommending the optimal treatment plan. When checking the breasts, the surgeon will assess multiple elements such as the dimensions of the thorax, the size and shape of the breasts, signs of ptosis, or asymmetries. If there is a certain level of breast ptosis, he will need to evaluate it to know if the patient can undergo a breast augmentation or a breast lift. Many patients believe that the breast lift is not necessary when wanting to get implants as they believe the breasts will be lifted once the implants are inside them. Unfortunately, this is not true. Moreover, if you get big implants on breasts that are severely sagging, the drooping will be more accentuated. Another thing that can happen is for the implants to stay high on the chest if inserted under the pectoral muscle while the rest of the mammary gland is sagging on the chest wall. Unsatisfactory results are almost guaranteed when inserting implants in breasts with ptosis. However, if the patient has just a slight case of breast ptosis, getting implants will improve their appearance. After the initial meeting with the surgeon, he will recommend the right procedure for you depending on your anatomy and desires and will also give you a cost estimate. Difference between breast augmentation and breast lift As stated in the definition of the two procedures, we get a breast augmentation to increase the size of the breasts and a breast lift to get perkier breasts that are higher on the chest wall. The procedures can’t be a substitute for the other. If you can’t get a breast lift to increase the size of the breasts, then you certainly can’t correct sagginess with an augmentation either. People might get confused when it comes to these two procedures also because a surgeon can recommend a breast lift with implants. On the outside, the result will be the one of a breast augmentation and the patient will have perky, full breasts. But to create this result, breast lift surgery techniques will be used. In other words, the incisions used will be for a breast lift and not for a breast augmentation. For breast augmentation, we have multiple options for the placement of the incision (around the areola, in the inframammary fold, and in the axilla), but only one incision per breast is needed to introduce the implants. When it comes to performing the breast lift, we can have up to three incisions (usually one is around the areola in case of the reposition of the nipple/ areola complex, one in the inframammary fold, and one from the edge of the areola toward the inframammary fold). The results of a simple breast lift are breasts that look younger and are perkier, but often smaller in terms of size due to the elimination of skin and fat tissue. This is the reason why many patients requesting a breast lift choose to have implants inserted at the same time. While breast augmentation is requested by women of all ages, starting with 18 years old (for saline implants) and 22 years old (silicone implants), the breast lift is often recommended for women after a certain age when ptosis occurs as a result of aging. Conclusion Plastic surgery for breast enhancement includes three main categories: reductions, augmentations, and lifts. While things are pretty clear when it comes to breast reduction surgery, the breast lift is often considered as being able to be substituted with breast augmentation with implants. This is not true. Breast implants can be used to correct minor ptosis, but when using implants for breasts with moderate or severe ptosis, this will only lead to a more accentuated sagginess of the breasts. The procedure that is most suitable for your particular anatomy and in line with your desires will be recommended by the plastic surgeon during the initial consultation. This is the time when the surgeon will take the time to assess your health condition, ask about your medical history and allergies, and also perform measurements to determine what procedure is best for you.