Breast Surgery in Fort Myers: Lift, Augment, or Both at Farahmand Plastic Surgery

Breast surgery decisions rarely hinge on a single goal. Most women who visit our Fort Myers practice come with a cluster of priorities: restore upper pole fullness after pregnancy, correct asymmetry that has always bothered them, lift tissue that sits lower than they would like, or refine shape while keeping the result believable in a swimsuit and under a fitted dress. The question often crystallizes into a choice between a breast lift, breast augmentation, or a combined procedure. The right plan depends on anatomy, lifestyle, and how you want to look a year from now, not just six weeks after surgery.

What follows reflects the day-to-day decision making we use at Farahmand Plastic Surgery. It is informed by the patterns we see in consults and the trade-offs we discuss when designing a surgical plan that fits a patient’s body and goals.

What you’re really choosing: shape, position, and proportion

When patients ask whether they “need” a lift or “should” get implants, we start with three variables that account for almost every aesthetic concern.

Shape is about contour and distribution of volume. A round, tight breast with strong upper fullness reads very differently from a teardrop shape with most volume below the nipple. Position refers to where the breast sits on the chest, including nipple location relative to the inframammary fold. Proportion is the relationship of breast size to your shoulders, ribcage, and hips, along with how clothing fits.

A breast lift directly addresses position and improves shape by tightening skin and repositioning the nipple-areola complex. A breast augmentation directly adds volume to improve shape and can nudge proportion in the direction you want. A combined augmentation with lift addresses all three in one operation, though not everyone needs all three addressed at the same time.

How surgeons assess ptosis, volume, and skin quality

Surgeons measure, but we also look and listen. Numbers matter, yet two patients with the same measurements may need different plans because of skin elasticity, ribcage shape, and personal style.

We evaluate nipple position relative to the inframammary fold, the degree of skin laxity, the quality and thickness of the tissue envelope, and how much upper pole volume is present when supported in a bra. If the nipple sits at or below the fold, a lift usually enters the conversation. If the breast appears “deflated” despite acceptable nipple position, augmentation alone may be appropriate. When there is both deflation and low nipple position, the combined approach offers the most complete solution.

There is also the matter of skin behavior. Some patients have resilient skin that shrugs off gravity with a small assist. Others have skin that stretches early and often, especially after weight changes or breastfeeding. Skin quality influences incision choices, lift patterns, and implant selection.

When a breast lift makes the most sense

A mastopexy, or breast lift, reshapes the breast using your existing tissue. It tightens the skin envelope, repositions the nipple and areola, and recontours the lower pole. For women who are happy with their current volume in a supportive bra but unhappy with how their breasts sit without support, a lift alone can be the right answer. Think of it as tailoring rather than adding fabric.

Common scenarios include post-breastfeeding elongation with low nipple position but adequate fullness when scooped into a bra. It also suits women who have lost weight and find that skin laxity hides their natural shape. In these cases, adding an implant to compensate for laxity often misses the mark. An implant can make the lower pole heavier, which may worsen descent over time if the skin is not reinforced by a lift.

The trade-offs with a lift are visible scars that fade but do not disappear. The usual patterns are periareolar, vertical (lollipop), or Wise pattern (anchor). The choice depends on how much repositioning and skin removal are needed. In competent hands, scar placement and meticulous closure create fine lines that sit along natural curves, and most patients consider them worth the improvement in shape and position.

When breast augmentation alone is the better path

Augmentation adds volume to restore or enhance proportion. It works best when nipple position is at or above the fold and the breast footprint is in a good place. If your complaint is flatness at the top or a persistent gap in bras that should fit, a well-chosen implant can do the job without the cost and scars of a lift.

Women with mild deflation after pregnancy or women who always felt under-proportioned relative to their shoulders and hips often benefit from augmentation alone. The key lies in picking size and projection that respect your chest width, tissue quality, and lifestyle. A marathoner with a narrow ribcage typically needs a different implant profile than a weightlifter with a broader build.

The trade-offs here involve implant maintenance and the risk profile of devices. Implants are not lifetime devices, although many last 10 to 20 years or longer. You should be comfortable with the possibility of future surgery, whether for routine exchange, addressing capsular contracture, or managing implant-related changes after weight fluctuations or pregnancies. Modern silicone and saline implants are both safe and well studied. Each has strengths worth discussing in the context of your goals and anatomy.

Why combine augmentation with a lift

When the breast has both lax skin and volume loss, combining a lift with breast augmentation often achieves the most natural and durable result. The lift repositions and reshapes, while the implant restores upper pole fullness and proportion. Trying to correct significant ptosis with an implant alone forces the device to do a job it was not designed for, and sizing up to create a “lift” frequently leads to a heavy lower pole, widened scars later if a lift becomes necessary, and a shape that falls faster than expected.

At our Fort Myers practice, we see this combination work well for patients after breastfeeding who want their pre-baby shape back, not a dramatic size change. It also suits patients after weight loss who lost volume and projection. The synergy matters. A conservative implant with a precise lift can deliver a youthful contour that holds up in and out of clothing, avoiding the overfilled look that attracts attention in the wrong way.

The trade-offs include a longer operation, more incisions, and a slightly more complex recovery in the first two weeks. The upside is a single anesthesia event, one healing period, and a cohesive result.

Incision patterns and what they mean day to day

Scar placement is a daily concern for patients, and it deserves frank discussion. Periareolar incisions circle the areola and work for minor lifts, small reductions in areolar size, or straightforward augmentations when an areolar approach is chosen. Vertical incisions add a line from the areola to the fold, allowing real shaping of the lower pole. Wise pattern incisions add a hidden line in the fold, which is often necessary for more significant shaping and skin removal.

Scars evolve. They start pink, flatten, and fade over 6 to 18 months. We emphasize scar care, which includes silicone therapy, sun protection, and, when needed, laser resurfacing. The visibility of scars in swimsuits or underwear can be minimized with careful planning. Patients who respect the recommended scar care protocol consistently report high satisfaction with the trade.

Implant selection and the art of proportion

Most patients come in with a number in mind, often a cup size or a volume based on a friend’s surgery. We start by measuring the base width of your breast and the breadth of your chest. Implant selection follows the rule of fit first, then preference. A device that matches your footprint produces a natural slope and minimizes lateral spill. Projection choices shape the profile: lower projection for a softer, more athletic look, moderate for balanced fullness, higher projection when you need more central projection without excess width.

Saline and silicone each have roles. Silicone feels more like natural tissue, especially in thinner patients, and tends to ripple less. Saline allows smaller incision length and offers immediate detection of a deflation if it occurs. Gummy cohesive gel devices hold their shape well and can better maintain upper pole contour in some cases. The best choice reflects your tissue characteristics, activity level, and sensitivity to maintenance considerations.

Submuscular versus subglandular placement also matters. Under the muscle can yield a more natural slope in thinner patients and reduces the risk of palpable edges, but it may cause animation changes during chest exercises. Over the muscle can produce a softer drape in women with thicker tissue and avoids animation, but requires sufficient coverage to avoid visible edges. A dual-plane approach blends benefits by partially releasing the lower muscle attachments, often ideal in combined lift-augmentation cases.

How recovery really feels: the first six weeks

Day to day, patients care about when they can raise their arms comfortably, sleep without a stack of pillows, and resume life. With augmentation alone, soreness peaks during the first 72 hours, then steadily improves. Many patients return to desk work in 3 to 5 days. With a lift, particularly a Wise pattern, the discomfort shifts from muscle soreness to skin tension. Plan on one to two weeks before you feel up to the usual routine, with gentle walking encouraged early to reduce stiffness.

A combined procedure blends the two. Expect tightness across the lower pole from the lift and a heavy-chested feeling from the implant. Most patients sleep propped on their back for the first week, then transition to side sleeping with a supportive pillow. Lifting toddlers or heavy groceries should wait until you clear it at your follow-up. Light lower-body exercise can resume after about two weeks if incisions are healing well, while chest-focused workouts typically wait six weeks.

Swelling waxes and wanes for several months. Early results look high and tight; implants settle as lower pole tissues relax and the muscle accommodates. True “final” shape emerges around 3 to 6 months, and scars continue improving beyond that.

Safety, longevity, and how to think about future maintenance

No operation is risk-free. We review standard risks like infection, bleeding, delayed healing, and asymmetry. For implants, we also discuss capsular contracture, device rupture, and the very rare risks associated with textured devices that are largely not used in the United States today. It is crucial to know your device type and to attend periodic follow-ups. For silicone gel implants, the FDA recommends periodic imaging to screen for silent rupture. Many women opt for MRI or high-resolution ultrasound on a schedule discussed during consults.

A lift without implants involves fewer device-related variables but still responds to time, gravity, and life changes. Major weight fluctuations and pregnancies can alter results regardless of the technique used. We plan with your horizon in mind. If you intend to expand your family soon, it may make sense to defer a lift or choose a conservative strategy that accepts small compromises now to avoid redoing the work later.

Scenarios from practice: what tends to work best

We often meet three types of patients facing this decision.

The first is the post-breastfeeding patient with adequate base width and mild deflation but nipples still above the fold. These women usually do well with a well-fitted augmentation alone, often in the 200 to 315 cc range depending on chest width. They gain upper pole fullness without needing lift scars.

The second is the weight-loss patient with stretched skin, low nipple position, and variable volume. Here, a lift makes the biggest visual difference. If the patient wants more size or the upper pole is depleted, we add a modest implant. https://caidendwtm765.almoheet-travel.com/choosing-saline-vs-silicone-for-breast-augmentation-in-fort-myers Attempting to skip the lift and size up typically looks bottom-heavy and ages the result quickly.

The third is the naturally small-chested patient seeking proportion. Augmentation alone is typical, using an implant that respects base width and matches athletic or curvy goals. When the nipple sits slightly low yet not below the fold, a subtle lift can refine position, but we only add it if measurements and photographs show a consistent need.

The role of liposuction and body contouring in shaping the result

Breast aesthetics do not exist in isolation. The interplay between the lateral chest wall, the axillary fold, and the upper abdomen shapes how the breast looks from every angle. Strategic liposuction in the axillary tail or lateral bra roll can sharpen the border and make the breast look more lifted, even before a scalpel touches the breast itself. For mothers considering broader restoration, pairing breast surgery with a tummy tuck can create balanced contours that amplify the breast result. The sequence and combination depend on health and recovery bandwidth. Not everyone needs both, and sometimes staging procedures improves safety and precision.

Sensation, breastfeeding, and functional questions

Sensation changes are possible with any breast surgery, more likely with larger lifts and greater nipple-areola repositioning. Most patients experience temporary sensitivity changes that normalize over months. A small percentage may have persistent changes, which we discuss thoroughly in consult. With implants placed via inframammary incisions and modest lifts, many women retain breastfeeding potential, but no surgeon can guarantee it. If breastfeeding is a high priority in the near future, timing your surgery accordingly deserves serious consideration.

How we guide sizing without guessing

Sizing is not a coin flip. We use a combination of tape measurements, implant sizers during a fitting session, and 3D imaging when appropriate. Trying on sizers inside a non-padded bra under a fitted top gives a concrete sense of daily life. The 3D images help visualize projection and width, but they are a guide rather than a promise. We record what you like, how it looks from the side and three-quarter views, and how your shoulders and waistline frame the change. The final implant choice often sits within a narrow range, and intraoperative assessment fine-tunes within that range for symmetry and soft tissue balance.

Realistic timelines for special events

Patients often plan surgery around weddings, beach seasons, or photo shoots. If you want to feel polished in a strapless dress with minimal evidence of surgery, build in a buffer. For augmentation alone, three months is comfortable, six weeks acceptable if you can tolerate some swelling and a slightly higher implant position that will continue to settle. For lift or lift-augmentation, aim for three to four months to allow scars to mature and the lower pole to relax. If you have a strict timeline, let us stage expectations so your dress choice and tailoring match your healing phase.

Cost, value, and how to think about budget

Price reflects professional fees, facility and anesthesia costs, and the complexity of your procedure. Combining a lift with augmentation is more costly than either alone, but it may save money and downtime compared with staging two separate operations. We are transparent about options that protect your budget without compromising outcome. Sometimes that means choosing a smaller implant and a more efficient lift pattern, or delaying ancillary liposuction. What we avoid is false economy, like omitting a needed lift to save on scars only to end up with a shape you do not like and a second operation later.

Choosing a plastic surgeon and what to ask

The consultation matters more than the ad. Ask to see before-and-after photos that match your body type and goals. Look for consistent nipple positioning, clean lower pole curves, and symmetry across multiple cases. Ask about capsular contracture rates, revision policies, and how the practice supports scar care. Clarify recovery logistics, including contact protocols after hours. A board-certified plastic surgeon with experience in breast augmentation, breast lift, and combined procedures will walk you through the decision tree without pushing a single solution.

Here is a brief checklist some patients find helpful to bring to their visit:

What is my degree of ptosis and how does that influence the need for a lift? Which implant sizes and profiles fit my measurements, and what are the trade-offs of each? Which incision pattern would you recommend for my goals and why? How will this plan look in motion and in everyday clothing, not just in a static photo? What is the anticipated maintenance or likelihood of future surgery over the next 10 to 15 years?

How Farahmand Plastic Surgery approaches planning and follow-up

At our Fort Myers practice, the first visit is a conversation as much as it is a measurement session. We photograph with consistent views for comparison, discuss your daily life and athletic habits, and review examples of results that resemble where you want to land. We involve you in implant try-ons so that the selection feels collaborative, not dictated. If a lift is on the table, we explain scar patterns with diagrams and show healed examples so you can judge what the trade looks like months later, not just on day 10.

Postoperatively, we schedule frequent early follow-ups to guide activity and catch small issues before they grow. Scar management starts as soon as incisions close, usually around the two-week mark, and continues for several months. If your implants are silicone, we outline an imaging schedule and provide documentation of device details for your records. For patients traveling within Southwest Florida, we coordinate recovery check-ins around work and family obligations to reduce stress.

Edge cases and special considerations

Tubular breast features, significant asymmetry, chest wall irregularities, or a high, tight fold may require staged or modified approaches. In tubular cases, we often blend release techniques, lower pole expansion, and careful implant selection to achieve a rounder shape. For marked asymmetry, combining different implant volumes or profiles, and occasionally a unilateral lift, creates better balance. Athletic women who do heavy chest work may prefer over-the-muscle placement or accept minor animation to secure the most natural slope. These are not textbook calls; they are judgment calls made with you after reviewing realistic outcomes.

Life after surgery: living with the result

Once healed, the best outcomes fade into the background of daily life. Bras fit the way they should. Workout tops lie flat without shifting. Dresses skim rather than cling. The result you can forget is usually the best result, and that comes from proportionate choices and respect for your anatomy. Over years, maintain a stable weight, support your scars from the sun, and keep up with recommended check-ins. If life changes call for adjustments, your surgical history and photographs help us build the next good decision on the last good decision.

Bringing it all together

The choice between a breast lift, breast augmentation, or both is not about trends or a single measurement. It is about how you want to look and feel in your own skin, with decisions grounded in your anatomy and goals. At Farahmand Plastic Surgery in Fort Myers, we use the full toolkit of plastic surgery to deliver results that look right for you, not for a social feed. Some patients find new confidence with a thoughtful augmentation. Others rediscover their shape with a precise lift. Many benefit from the synergy of both.

If you are unsure which path fits, that is normal. Bring your questions, your favorite dress or top, and an open mind. We will bring clear explanations, photographs that match your frame, and a plan that respects both the art and the science of breast surgery. Whether your journey also includes liposuction for the lateral chest or a tummy tuck as part of a broader body contouring plan, the aim is the same: a result that looks natural in motion, holds up over time, and feels fully your own.

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Pub: 05 Feb 2026 11:02 UTC

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