Breast lift and augmentation: when the combination is the right choice for you

For some women, the breasts are not only too small or only sagging. They are both: after pregnancy, breastfeeding, or weight loss, they lose fullness and at the same time descend, the nipples point downwards, and there is “emptiness” in the upper pole.

In such cases, breast augmentation with implants alone is often not sufficient, and neither is a breast lift alone. This is where a combined procedure comes into consideration: breast lift and augmentation (augmentation mastopexy), where in one operation we lift the breasts and simultaneously restore volume.

At Klinika Višnjar, we perform breast lift, augmentation with Motiva® implants, fat transfer breast augmentation, hybrid breast augmentation, and advanced methods such as MIA Femtech® and Motiva® Preservé. We always decide on an individual basis, including whether a combined lift and augmentation makes sense for you.

Below, we explain when we consider a combined procedure, how it is performed, and what results you can realistically expect.

Signs that an implant alone or a lift alone will not be enough

We typically consider a one-stage breast lift and augmentation when:

• after pregnancy or weight loss, the breasts have lost volume, especially in the upper pole
• the nipples point downwards or sit below the inframammary fold
• the breasts look good in a bra, but without it they appear empty and “saggy”
• the upper part of the cup is empty, while the skin folds in the lower part
• you would like the breasts lifted, but also slightly fuller than before
• an implant alone would further weight the breast and “pull” it downwards (the so-called waterfall deformity)
• a lift alone would create a nice shape, but you would still miss volume in clothing

With mild sagging, augmentation alone may sometimes be sufficient. With more pronounced sagging (ptosis) and “deflation”, the combination of lift and augmentation is often the most logical choice, because it addresses both volume and breast position at the same time.

Why breasts descend and “deflate”

The most common reasons are:

• pregnancy and breastfeeding (skin stretching and changes in glandular tissue)
• major fluctuations in body weight
• natural ageing and loss of skin elasticity
• genetics (even younger women can have more pronounced ptosis)

When glandular tissue decreases while the skin remains stretched, breasts can look “deflated” and descended. In such cases, adding volume with an implant without a lift often results in breasts that are too heavy and even more ptotic over time. That is why we combine a lift (excision of redundant skin, elevation of breast tissue and the nipple-areola complex) with an implant to restore fullness.

The psychological aspect: from “empty” to full again

Women coming for consultation often say similar things:

• “In a bra it still looks okay, but without it my breasts are completely empty.”
• “After two children, I no longer recognise myself in the mirror.”
• “It’s not that I want huge breasts, I just want my shape back.”

Studies on patient-reported outcomes after mastopexy and combined procedures report high satisfaction rates, improved self-image, and better quality of life in most patients.*

Our goal is that after surgery you recognise yourself again in the mirror, with breasts that resemble what you had before pregnancy or major weight changes, only more in harmony with your current body.

What we do during the combined procedure

Dvig in povečanje prsi pomeni, da v enem posegu:

• dvignemo povešeno tkivo prsi
• po potrebi zmanjšamo in preoblikujemo kolobar
• bradavico prestavimo višje, v bolj mladosten položaj
• odstranimo odvečno kožo, ki povzroča povešenost
• vstavimo vsadek (ali po dogovoru delno dopolnimo volumen z lastno maščobo)

Rezultat so bolj dvignjene, polnejše prsi, z lepšim zgornjim delom (“poln dekolte”), ki bolje sledijo telesu.

Na Kliniki Višnjar za povečanje prsi uporabljamo vsadke Motiva® in tudi napredne minimalno invazivne tehnike, kot je Motiva® Preservé. Pri kombinaciji dviga in povečanja skupaj izberemo metodo glede na vaše želje, količino potrebnega volumna, kakovost kože in željeno velikost.

 Implant and size selection

We do not choose implants “by eye”. At the consultation we:

• measure the chest, breast base width, and assess skin quality
• review reference photos to understand what you like (more natural vs more enhanced)
• explain the differences between Motiva® implant models and volumes
• review a 3D simulation using the Crisalix 3D computer model

In combined lift and augmentation, we always aim to ensure the implant is not too large for your skin and tissue. An oversized implant in ptotic breasts increases the long-term risk of recurrent sagging.

 Incision patterns and scars in lift and augmentation

Scars are unavoidable with a breast lift. The scar pattern depends on the degree of ptosis and the amount of redundant skin:

• for smaller corrections, an incision around the areola (periareolar) may be sufficient
• for moderate ptosis, we most often use the so-called “lollipop” (around the areola plus a vertical incision)
• for more significant ptosis and larger breasts, an additional incision in the inframammary fold is needed (“anchor” pattern)

Scars are initially pink and more visible. Over months they gradually fade and soften. Long-term, they tend to be discreet, and most patients consider them an acceptable trade-off for lifted, fuller breasts and easier dressing and movement.

Before surgery, we explain exactly where the incisions will be and show examples of typical scars after healing.

Is lift and augmentation always done in one operation?

In most cases at Klinika Višnjar, we perform the combined procedure in a single operation (a one-stage approach). In certain cases, such as very poor skin quality or the need for a very large volume increase, we may consider a two-stage approach (lift first, then augmentation, or the reverse, depending on the case).

The decision is always individual and made at consultation based on:

• degree of ptosis
• skin quality
• desired implant size

How recovery progresses after lift and augmentation

Recovery after a combined procedure is somewhat more intensive than after augmentation alone, but it follows a predictable pattern:

• first days: swelling, tightness, and moderate pain controlled with medication; you wear a dedicated compression bra
• 1–2 weeks: most patients return to light work; we still restrict lifting and repetitive overhead arm movements
• 6–8 weeks: gradual return to sport and more intensive activity, after surgeon approval
• 3–6 months: the breasts “settle” into the final shape, scars fade, and breast sensation gradually normalises

From the start until the final result, we follow you with check-ups, written instructions, and the option to contact us during recovery whenever you are concerned.

How long results last and satisfaction rates

The combination of lift and augmentation is among the more demanding but also highly effective procedures when well planned.

Research* reports:

• high patient satisfaction (around 90% or higher)
• significant improvements in self-esteem and quality of life
• relatively low revision rates when implant size is selected realistically based on tissue capacity

The result is not “frozen”. Breasts still change with natural ageing and gravity. Implants are long-term devices, but not necessarily “lifetime”. At some point, you may want a correction or implant exchange, which we explain clearly at consultation.

Risks you should be aware of

As with any surgical procedure, there are risks:

• bleeding, infection, impaired wound healing
• more visible or widened scars
• temporary or permanent changes in nipple sensation
• breast or nipple asymmetry
• capsular contracture (thickened capsule around the implant)
• need for further correction or implant exchange in the future

At consultation, we speak openly about what the procedure can achieve, what you may gain, and what risks you must accept for the decision to be truly informed.

Patient experience: “from empty and sagging to full and lifted”

“After breastfeeding two children, my breasts were practically empty. In a bra I could still somehow ‘put them together’, but without it the cleavage was empty and the nipples pointed downwards. I knew an implant alone would not solve the problem, because it would only add volume in the same low position.

At the consultation at Klinika Višnjar, Dr Višnjar and I agreed on a breast lift and augmentation with Motiva implants. It helped a lot that they explained what the scars would look like, what size they recommended for my body, and what I could realistically expect.

The first weeks after surgery I was tired and very careful about how I moved, but everything went according to plan. After a few months, I wore a plain, simple T-shirt for the first time in my life without padded support, and my breasts had shape even without tricks.

It is not just about aesthetics. I feel more ‘put together’, as if my body finally fits again. I do not regret a single day.”

Where to start if you are considering lift and augmentation

If you are deciding whether augmentation alone, a lift alone, or a combination is the right option for you, the first step is a consultation.

You can read more about breast augmentation options and techniques we use here:
Breast augmentation with Motiva® implants – Klinika Višnjar

At the consultation, together we:

• assess breast shape, volume, and degree of ptosis
• determine whether a lift, augmentation, or a combined procedure makes most sense for you
• explain likely scars, implant selection, and the recovery process
• answer all questions regarding results and risks

Our goal is clear: breasts that feel “yours” again, lifted, full, and aligned with your body and lifestyle.