Breast Augmentation vs. Breast Lift: Which Is Right for You?

Do I need a breast augmentation or a breast lift?

Dr. Nodwell hears this question practically every day. Some women want more fullness, some want their breasts to sit higher, and many want both. Deciding which procedure — or combination — fits your goals requires detailed assessment, realistic goal-setting, and expert guidance. 

This guide will help you sort through what each procedure does, what it doesn't do, and how to know which approach is right for you.

Breast Augmentation: Adding Volume and Fullness

Breast augmentation with implants or fat transfer increases breast size and fullness and improves breast shape.

What Does Breast Augmentation Do?

Breast augmentation centers on volume-related concerns. Small breasts increase in size and projection. The upper pole of the breasts gains fullness to produce better cleavage. Asymmetries in size (though not necessarily position) can be balanced. The procedure excels at enhancing curves for women who are naturally flat-chested and restoring curves for women who have lost volume after weight loss, pregnancy, or breastfeeding.

What Doesn't Breast Augmentation Do?

What augmentation doesn't address often surprises patients who assume implants solve everything. Sagging breast tissue remains sagged, just larger. Low nipple position stays low. Excess skin doesn't magically tighten around implants. In fact, adding weight to already-sagging breasts can lead to worse positioning over time.

Who Is a Good Candidate for Breast Augmentation?

Ideal candidates for breast augmentation primarily seek enhanced volume rather than a lifted position. Young women who've always had smaller breasts, mothers whose breasts have lost volume but maintained position, and those with congenital asymmetries often achieve their goals through augmentation alone.

Breast Lift: Restoring Youthful Position

A breast lift (mastopexy) serves women who feel satisfied with their breast size but frustrated by sagging or a low position. 

What Does a Breast Lift Do?

Breast lift surgery focuses on position and shape rather than size. Low nipples are elevated to a youthful height, and the nipple-areola complex is centered on the breast mound. Loose, excess skin is removed, and the overall breast shape improves from a deflated, elongated appearance to a rounder, perkier profile.

What Doesn't a Breast Lift Do?

A breast lift does not address volume concerns. The procedure doesn't add fullness — in fact, removing excess skin can make breasts appear slightly smaller, although technically no volume is removed. Upper pole fullness doesn't magically appear; if there is a hollow area above the nipple, it will remain unless breast implants are included in the procedure.  

Who Is a Good Candidate for a Breast Lift?

Ideal breast lift candidates have adequate breast volume, significant sagging or nipple malposition, good overall health, and realistic expectations about scarring. A quick at-home trick called the "pencil test" gives you a rough idea of whether you might benefit from this procedure. Place a pencil under your breast crease and let go. If it stays put without you holding it, or if your nipple sits at or below the level of the pencil, you likely have some degree of sagging.

The Combination Approach: Breast Augmentation + Lift

For many women, the most natural and satisfying results come from combining a breast augmentation with a lift. This approach addresses concerns about fullness and position at the same time. 

If your breasts have lost volume and sit lower on your chest (which often happens after pregnancy, breastfeeding, weight changes, or aging), doing one procedure alone may leave part of the problem unresolved. Implants by themselves can add size and improve cleavage, but they can't lift tissue that is sagging. A lift restores shape and height, but it doesn't add fullness.

Combining augmentation and lift allows you to achieve complete breast rejuvenation. The result is a fuller, more shapely breast that sits higher on your chest and feels balanced with your body. 

How Do Age and Life Stage Factor In?

Young women often seek augmentation alone, as significant sagging rarely occurs before pregnancy or major weight changes. Their skin elasticity usually supports increased volume well without needing a lift.

• ‍Post-pregnancy patients often need both, since pregnancy and breastfeeding can stretch skin and deflate volume. Some do well with implants alone if the position is good.‍
• Post-weight loss patients almost always require a lift due to significant skin excess. Major weight loss deflates breast tissue while leaving excess skin that no amount of volume can fill attractively.  ‍
• With age, progressive sagging eventually affects everyone. This is an ideal time for a breast lift, and if volume loss is experienced concurrently, breast implants may also be beneficial.

What Should I Ask Myself Before Deciding?

Here are a few questions that can help clarify your choice between breast augmentation, lift, or combination surgery:

• Am I more bothered by size or position? If you had to choose between bigger breasts or higher breasts, which would improve your confidence more? 
• What are my aesthetic goals? Are you seeking restoration to a previous state or enhancement beyond what you've had? Do you prioritize natural appearance or dramatic change?  
• How do I feel about potential scarring? Lifts typically involve more scarring than augmentation. Consider your comfort with this trade-off.  
• What's my tolerance for revision surgery? Implants aren't lifetime devices and may require replacement. Are you open to that possibility?
• Do I want one surgery or am I open to staging? A combination can often be done at once to limit your recovery time, but sometimes it's safer to separate procedures. 

Breast Augmentation vs. Breast Lift: The Bottom Line

If your breasts sit well but you want them larger, implants are usually the answer.

If your breasts sag but you like your size, a lift restores youthful position.

And if you struggle with both concerns, as many women do, combining the two procedures provides the most complete, natural-looking results.

The importance of surgeon expertise in breast surgery cannot be overstated, particularly for combination procedures. Board certification ensures basic competency, but fellowship training like Dr. Nodwell's provides the advanced skills necessary for complex breast enhancement. This expertise translates directly to safer surgeries, better results, and higher patient satisfaction.

Request a Consultation With Ottawa's Breast Surgery Expert

Confused about which breast procedure you need? Let's assess your options together. Schedule a consultation with Dr. Nodwell to discuss your goals and develop a personalized surgical plan. Whether you need augmentation, lift, or a combination approach, Dr. Nodwell's expertise and honest guidance will help you choose the enhancement that brings you confidence for years to come.