Lifting Sagging Breasts: Lift vs. Implants vs. Both
Drooping breasts (breast ptosis) are a normal part of aging, weight change, pregnancy, and breastfeeding. Although it is normal, it’s not necessarily comfortable. If you are looking to reverse some of these changes, Fort Worth Breast Lift Surgeon Dr. Emily Kirby offers four proven ways to restore a more youthful breast shape: mastopexy (breast lift), breast augmentation with implants, a combined breast lift with implants, or a combination with fat grafting. Below, we explain how each option addresses sagging and who may be a good candidate.
Why Breasts Sag
Gravity, stretched ligaments, and reduced skin elasticity allow breast tissue to migrate lower on the chest over time. When the nipple sits at or below the breast fold, patients often describe their breasts as “deflated” or “droopy.” A customized surgical plan can reposition breast tissue, raise the nipple, improve firmness and stability, and restore upper-pole fullness.
1. Breast Lift (Mastopexy)
What it does: A breast lift reshapes existing tissue, elevates the nipple-areola complex, and removes excess skin to create a higher, rounder breast mound.
Recommended for:
- Patients satisfied with current cup size, but unhappy with breast position
- Those who notice nipples pointing downward
- Individuals seeking firmer, perkier contours without added volume
Limitations: A breast lift does not enlarge the breast; volume remains roughly the same. Patients wanting a fuller appearance may choose to add an implant or fat graft to fill out the upper pole.
Related: What is an auto-augmentation breast lift?
Breast Lift Before & After Insight
Lift-only photos show a noticeable “perking up” effect: nipples centered, breast mound higher, and subtle side-view projection.
This 44-year-old patient desired a lifted breast appearance after pregnancy and breastfeeding. Dr. Kirby performed a full “anchor” mastopexy to achieve her goals.
2. Breast Augmentation With Implants
What it does: Breast augmentation uses silicone or saline implants to add volume, enhance cleavage, and improve upper-pole fullness. Mild sagging sometimes improves because the implant fills loose skin.
Recommended for:
- Patients whose primary concern is size
- Those with minimal ptosis (nipple above the fold)
- Individuals wanting a rounder, fuller silhouette
- Patients with minimal stretch marks and laxity
Limitations: Breast implants alone cannot correct moderate to severe sagging; the nipple will still sit lower on the breast, and added weight can accentuate droop over time.
Related: Preservation Breast Augmentation: What is it, and is it right for you?
Breast Augmentation Before & After Insight
Our breast augmentation-only gallery shows examples of fuller projection and larger cup size, while nipple position changes little.
3. Breast Lift + Implants (Augmentation-Mastopexy)
What it does: Breast lift with augmentation combines a surgical breast lift with placement of breast implants to remove excess skin, elevate breast tissue, and add volume in a single surgery, addressing shape and size at once.
Recommended for:
- Patients with moderate-to-significant sagging, who also desire more volume
- Women seeking both perkiness and noticeable cleavage
- Individuals wanting to correct asymmetry in size and position
- Patients seeking to shrink the areola size around the nipple
Limitations: The combined procedure involves more surgical steps and requires meticulous planning to balance lift tension and implant support. Choosing an experienced, board-certified plastic surgeon for a breast lift with implants is essential.
Related: 3 Things to Know About “Anchor” Mastopexy
Breast Lift + Implants Before & After Insight
These photos reveal improvements in nipple height and overall fullness, producing the most youthful transformation among the three options.
“Wow, where to start! Dr. Kirby is truly one top notch Dr. of Plastic Surgery. I researched for some time and after meeting her and her staff for a consultation I knew my search was over. My breast augmentation was a complete success and I couldn’t be more happy. Thank all of you for making me feel whole again and the compassion you showed me.”
4. Breast Lift + Fat Graft (Mastopexy-Fat Graft)
What it does: Breast lift with fat grafting combines a surgical breast lift with fat removed using liposuction to provide a subtle, natural-looking increase in volume while shaping the breasts. This procedure comes with the added benefit of contouring stubborn “problem areas” from which we harvest fat, such as the abdomen.
Recommended for:
- Patients with moderate-to-significant sagging who desire a small, natural-looking increase in breast volume
- Individuals wanting to correct asymmetry in breast/nipple position or a slight asymmetry in size
- Patients seeking to shrink the areola size around the nipple
Limitations: Results are typically more subtle than those of breast lift with implants. Fat transfer can increase breast volume by about 1 cup size. Further, because not all injected fat will survive transfer, you may require more than one fat transfer procedure to reach your desired breast volume. Talk with Dr. Kirby during your consultation about the different results possible with fat grafting versus breast implants to make the best decision for your body.
Related: What is upper pole fullness?
What to Expect From Surgery and Recovery
| Lift Only | Implants Only | Lift + Implants | Lift + Fat Graft | |
| Surgery time | ~2 hours | ~1 hour | ~2.5-3 hours | ~2.5-3 hours |
| Incisions | Lollipop or anchor | Inframammary fold | Anchor | Anchor + small liposuction & graft incisions |
| Typical downtime | 1 week for desk work | Same guidelines | Same guidelines | Same guidelines |
| Exercise | Light cardio at 2 weeks; full at 6 weeks | Same guidelines | Same guidelines | Same guidelines |
| Longevity | 10+ years with stable weight & UV protection | Implants last 10-15+ years; results maintained with supportive bras | 10+ years; results may outlast implants alone | 10+ years; results may outlast implants alone |
Related: Local Anesthesia During Breast Surgery? Here’s How PECS Blocks Help
How to Decide Which Approach Fits Your Goals
Scheduling a breast lift consultation in Fort Worth with Dr. Kirby is the best way to determine which procedure will achieve your desired results, but the guidelines below can help you start thinking through your options.
1. Evaluate nipple size and position
Stand sideways in front of a mirror. If the nipple lies below your breast fold, a lift (alone or with implants) is usually required.
2. Consider desired volume
If you want a larger cup size, implants are necessary. If you like your current size, a lift alone may suffice.
3. Review real patient photos
Dr. Kirby’s breast enhancement gallery showcases lift-only, implant-only, and combined procedure results. Comparing these images helps set realistic expectations. View each gallery here »
4. Assess skin quality
Skin laxity means that your skin does not easily bounce back when stretched. If you have significant laxity and stretch marks, you may benefit from the supportive effect of a lift, even when implants are placed.
5. Think long-term
A combined approach often delivers the longest-lasting perkiness because lifted tissue supports the implant’s weight.
No matter which breast enhancement option you choose, Dr. Kirby provides tailored recovery protocols, including supportive garments, scar care products, and guidance. She also monitors your healing progress to support a smooth experience and natural-looking results that align with your vision.
Schedule Your Fort Worth Breast Lift Consultation
Every woman’s breasts are unique, and so is the surgical plan that will achieve youthful contours. Female Fort Worth Plastic Surgeon Dr. Emily Kirby invites you to discuss which option can achieve the level of lift you desire while also improving any other aesthetic concerns you may have. Call or text 817-292-4200 to begin your transformation.
