This is a very common question in my practice. A breast lift is an excellent operation but leaves scars on the breast surface. Typically there is a circular scar around the areola, a vertical scar over the middle of the breast and possibly a horizontal scar over the underwire area (lower breast fold) at the base of the breast. An augmentation is usually done through a 3.5 cm scar well placed over the lower breast fold and when healed is almost invisible.
Hence the question; can I do a augmentation only without a lift?
The location of the lower breast fold never changes. Some women have a high set breast meaning the breast is located closer to the collar bone while others have a lower set breast located further away down the torso. This relative position cannot be changed by surgery. However, what changes is the relative position of the nipple on the breast mound. Typically the nipple is a few centimeters above the lower breast fold and over the center of the breast. With age and pregnancy/lactation related changes, it droops and assumes a much lower position. In such a person, if an augmentation alone is performed, the breast tissue and nipple appear to fall of the implant producing a very unaesthetic look. In other words, the implant appears higher on the chest with the breast tissue falling/drooping off it. Hence a lift is performed to re-center the nipple followed by placement of an implant. In women with larger breasts, a lift alone with re-arrangement of breast tissue will reshape the breasts well without need for implants.
Finding out if you have breast ptosis (droop)
Place a tape measure under one breast such that it lies horizontally in the lower breast fold; now pass the other end over the surface of the second breast while still maintaining the horizontal lie of the tape measure. If the nipple on the second breast (the breast with the tape measure across its surface) is below the level of the tape measure, then a breast lift is required.