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They are three main cosmetic procedures performed on the female breast: augmentations, lifts, and reductions. Within these three procedures, a wide variety of techniques can be used. Because every patient is unique, a different approach is required for every patient.
There are many choices in breast augmentation. These include silicone gel versus saline implants, the size and shape of the implant, if the implant is placed on top of or below the muscle, and the actual incision location.
Saline implants have been the work horse implant of the Cosmetic Surgeon for many years. Because of their thicker outer shell, they may show signs of visible rippling in some patients. Silicone gel implants, because of their thinner outer shell, may feel more natural and have less of a tendency to ripple.
Implants come in two basic shapes, round and teardrop. Round implants, which come in a choice of low, moderate, or high profile, provide a general increase in breast fullness. For someone with generally small breasts or breasts that have become loose because of childbearing, round implants are probably more satisfactory.
Teardrop implants, typically provide more fullness in the lower part of the breast below the nipple. They provide a gradual slope in shape of the implant from the top to the bottom. These implants are usually preferred by patients with small breasts, who request a much larger breast implant. The decision of which shaped implant to choose depends upon, not only the patient’s wishes, but what the surgeon feels will best match the patient’s dimensions.
Another decision that the patient needs to make is the location of the scar. The three common locations are under the breast, around of the nipple, and within the armpit. While all scars fade and look better with time, they are nonetheless permanent. There is no one location that is ideal, nor is one location safer than another. Since scars are permanent, the patient much must decide which location suits her the best.
Recovery time from breast augmentation surgery varies. Typically, implants placed above the muscle have less initial postoperative discomfort, and patients are usually able to return to activities sooner. When the implant is placed underneath the muscle, recovery time may be longer. However, in many patients, implants placed underneath the muscle have a more natural look and feel to them.
Breast lift surgery can be performed alone or in combination with breast reduction or breast implants. For patients whose breasts have dropped, it generally depends upon where the nipple level is. If the nipple is very low of the breast, inserting an implant may improve the upper part of the breast, but the nipple may still droop below the breast. With a breast lift, the nipple is elevated along with the breast tissue, and the skid envelope is moved to a higher position. With this, the nipple now sits higher on the breast wall.
With breast lift surgery, the nipple is lifted, but frequently, the patient is left with a breast shape that is flat above the nipple. In these cases, if the patient desires to have a fuller breast above the nipple, the surgeon may recommend an uplift, combined with a breast implant.
Breast uplift surgery requires more incisions, then breast implant surgery. Typically, they will be scars around the nipple and down from the nipple to the skin fold. While there are different techniques to lift the breast, they all require a certain amount of scarring. The amount of scarring however, is directly proportional to the about of lift needed.
Patient’s usually return to their pre-surgery activities within a few days to a few weeks after surgery.
Breast reduction is a very common surgery and is frequently covered by insurance. Breast reduction surgery either removes a lot of breast tissue to produce a significant reduction or just a little breast tissue to reshape and lift the breast. For breast reduction surgery to be successful, it is important to reduce the breasts enough so that there is not a lot of pressure on the breast skin and tissues that hold the breasts in position. Typically, the incisions and scars associated with a breast reduction surgery are similar to the incisions and scars performed during a breast uplift surgery.
Although breasts may be large, the majority of their size is below the nipple. As a result, the part of the breast above the nipple may remain flat. If a patient desires to have less breast size, but also additional fullness above the nipple, then she may require breast implants along with her breast reduction.
Breast reduction surgery essentially involves removing the excessive breast tissue and skin and then repositioning the nipple to a higher more normal position. The skin is close with sutures, and although the scarring may be excessive, it is typically acceptable by the patient.
Recovery time for breast reduction surgery is typically 10 to 14 days.
Today’s woman has a variety of options to improve the size and shape of her breasts in the hands of a competent Cosmetic Surgeon. Communication between the patient and her Cosmetic Surgeon is paramount to obtaining the best results, and having a happy, satisfied patient.
Richard A. Joseph, MD
Midwest Surgical Arts
1250 North Mill St. Ste 103
Naperville, IL 60563
(630) 717-8200 | MyCosmeticSurgeon.com
Dr. Richard A. Joseph selected this article for publication based on its clear, patient‑focused explanation of today’s leading breast reshaping procedures, including augmentation, lift, and reduction surgery. The article outlines key considerations such as implant materials, shapes, and placement, as well as the benefits and limitations of different incision locations. It also explores how lifts and reductions address changes in breast position, contour, and nipple height. By highlighting the importance of individualized treatment planning and open communication between patient and surgeon, the article reflects modern standards in safe, thoughtful, and personalized cosmetic breast care.