Patients researching breast surgery in Perth may be unsure whether their concerns relate mainly to breast volume, breast position, or both. Breast augmentation and mastopexy address different anatomical concerns. Augmentation relates primarily to volume, while mastopexy relates primarily to breast position and excess skin.
This article explains the differences between the two procedures, the factors a surgeon assesses at consultation, and what patients should understand about surgical planning, recovery, and scarring.
| This article has been written by Dr Mark Hanikeri, FRACS (Plastic and Reconstructive Surgery), based on clinical experience consulting on breast surgery in Perth for over two decades. It is intended as general educational information about the factors a surgeon assesses at consultation and does not constitute medical advice. The procedure that may be considered appropriate depends on clinical assessment during consultation. Outcomes vary between individuals. |
Understanding Breast Augmentation
Breast augmentation is a surgical procedure involving the placement of implants to alter breast volume and shape. The procedure adds volume to the breast and may produce changes in projection and overall fullness.
Breast augmentation may be discussed for:
- Naturally small breast volume
- Volume changes following pregnancy or breastfeeding
- Volume changes following weight loss
- Asymmetry where one breast has substantially less volume than the other
- Reconstruction following breast surgery or congenital differences
Augmentation alone does not address breast ptosis (drooping of the breast tissue). If the nipple-areola complex sits below the inframammary fold or the breast tissue itself has descended, augmentation alone may not produce the desired position or shape, and a lift procedure may need to be discussed.
Understanding Breast Lift (Mastopexy)
Mastopexy is a surgical procedure that removes excess breast skin, repositions the breast tissue higher on the chest wall, and reshapes the breast. The nipple-areola complex is also repositioned as part of the procedure, and the areola may be reduced in diameter where indicated.
Mastopexy may be discussed for:
- Changes in breast position after pregnancy and breastfeeding
- Changes following significant weight loss
- Age-related changes in breast tissue and skin elasticity
- Asymmetry where one breast sits significantly lower than the other
- Concerns about nipple-areola position relative to the inframammary fold
Mastopexy alone does not add volume. If concerns relating to both breast volume and breast position are identified, different surgical approaches may be discussed during consultation. If mastopexy is performed on its own, the existing breast volume is repositioned but not increased.
When Multiple Procedures May Be Discussed
In some cases, concerns relating to breast volume and breast position may both be assessed during consultation. Surgical planning depends on anatomy, tissue characteristics, overall health, and the clinical findings identified during assessment.
These procedures address different anatomical concerns and involve different surgical considerations. The suitability of performing more than one procedure is assessed individually based on anatomy, tissue characteristics, overall health, and surgical complexity.
In some situations, a staged approach may also be discussed. Recommendations vary depending on the individual patient and the findings at consultation.
Factors a Surgeon Assesses at Consultation
A breast surgery consultation involves detailed assessment of the factors that influence which procedure is most appropriate. The assessment is individual and requires physical examination – it cannot be performed reliably from photographs alone.
Degree of Ptosis
Ptosis (breast droop) is commonly classified using the Regnault classification, which describes the position of the nipple-areola complex in relation to the inframammary fold. Mild ptosis may sometimes be assessed as suitable for augmentation alone depending on individual anatomy and surgical planning considerations. More significant ptosis may lead to discussion of a lift procedure as part of surgical planning.
Breast Volume
Existing breast volume influences the procedure plan. Where breast volume is considered acceptable and the primary concern relates to breast position, mastopexy alone may be discussed during consultation. If limited breast volume and breast position are both concerns, different surgical approaches may be discussed during consultation. Where breast position is considered acceptable and the primary concern relates to volume, augmentation alone may be discussed during consultation.
Skin Quality and Elasticity
Skin quality affects how the breast holds its shape after surgery, particularly for augmentation alone. Where significant skin laxity is present, augmentation alone may not address all concerns relating to breast position or tissue distribution. In these cases, mastopexy may be discussed as part of the consultation.
Pregnancy and Breastfeeding History
Pregnancy and breastfeeding produce significant and often lasting changes to breast tissue, skin elasticity, and nipple-areola position. The pattern of changes guides the surgical plan. Patients who plan further pregnancies should discuss timing with their surgeon, as future pregnancies can affect surgical outcomes.
Patient Goals
The patient’s own goals for surgery – whether the primary concern is volume, position, shape, or some combination – are central to the discussion. Goals are discussed in detail at consultation and inform which procedures are appropriate to consider.
Scarring Differences Between Procedures
Patients commonly ask about scars. The two procedures involve different incision patterns:
- Breast augmentation scars – typically a single incision under the breast in the inframammary fold
- Mastopexy scars – depending on the technique, may include a periareolar scar (around the areola – donut), a vertical scar (from areola to inframammary fold – lollipop), or an anchor-shaped scar (periareolar, vertical, and along the inframammary fold)
- Scarring – When more than one breast procedure is discussed, scar placement and incision planning depend on the procedures being considered, the patient’s anatomy, and the surgical approach recommended during consultation.
Scar appearance changes considerably over the first year after surgery and continues to evolve for up to two years. The final scar appearance varies between individuals and depends on skin quality, healing response, and post-operative care.
Recovery Differences
Recovery varies depending on the procedure discussed, the surgical technique used, and individual healing factors. Patients undergoing breast augmentation may experience different recovery considerations depending on implant placement, incision approach, and tissue characteristics. Mastopexy recovery commonly involves wound care management, follow-up review, and monitoring of incision healing over time. Where augmentation and mastopexy are both discussed as part of the surgical plan, recovery considerations are assessed individually based on the extent of surgery and overall treatment approach. Detailed recovery guidance is provided following clinical assessment and surgical planning.
Frequently Asked Questions
Do I need a breast lift or breast augmentation?
This depends on the individual concerns being addressed. If the primary concern is volume and the breast position is acceptable, augmentation alone may be discussed. If the primary concern is breast position and the existing volume is acceptable, mastopexy alone may be discussed. If concerns relating to both breast volume and breast position are identified, the surgeon may discuss the factors influencing surgical planning following clinical assessment. Any recommendation is made during consultation following physical assessment.
Can you have a breast lift and augmentation at the same time?
In some cases, consultation may involve discussion of more than one breast procedure depending on the patient’s anatomy, tissue characteristics, and surgical considerations. Whether procedures are discussed separately, staged over time, or considered together depends on individual clinical assessment and suitability for surgery.
How does recovery vary between breast procedures?
Recovery varies depending on the procedure performed, surgical complexity, tissue characteristics, and individual healing factors. Your surgeon will provide specific recovery guidance after clinical assessment and surgical planning.
How do I know if I have breast ptosis?
Breast ptosis is assessed clinically by a surgeon based on the position of the nipple-areola complex relative to the inframammary fold. The Regnault classification is commonly used to describe the degree of ptosis. Assessment requires physical examination and cannot be made reliably from photographs alone.
Will a breast lift change my breast size?
Mastopexy alone does not add volume. It repositions the existing breast tissue and removes excess skin. If concerns about breast volume are also raised, this is assessed separately during consultation before any surgical approach is discussed. Some patients perceive a small change in apparent size following mastopexy due to the change in shape and projection, but the underlying volume is not significantly altered.
Next Steps for Perth Patients
Breast augmentation and mastopexy address different anatomical concerns, and the procedure discussed during consultation depends on factors such as breast volume, skin quality, nipple position, tissue characteristics, and individual goals. Clinical assessment is required before any surgical approach can be discussed in relation to the individual situation.
During consultation, Dr Mark Hanikeri discusses breast anatomy, surgical planning considerations, recovery factors, and the procedures that may be relevant following assessment. Dr Hanikeri holds FRACS in Plastic and Reconstructive Surgery and consults at accredited facilities in Perth.
Further Reading on Plastic Surgery in Perth
- About Dr Mark Hanikeri – markhanikeri.com/about-us/
- Breast Surgery Procedures – markhanikeri.com/breast/
- Facial Surgery Procedures – markhanikeri.com/face/
- Body Surgery Procedures – markhanikeri.com/body/
- Surgery Risks and Complications – markhanikeri.com/surgery-risks-and-complications/
| Written by Dr Mark Hanikeri – Specialist Plastic Surgeon, Perth WA. Dr Hanikeri holds Fellowship of the Royal Australasian College of Surgeons (FRACS) in Plastic and Reconstructive Surgery and has practised in Perth for over two decades. Consultations are conducted at accredited facilities in Subiaco and Murdoch. |
