Perhaps getting a third opinion might help. Either way, I would recommend being open and honest with each surgeon letting him/her know that you consulted w/ another doctor and explain what was recommended, followed by asking why their recommendation is different. The surgeon who suggested two separate surgeries is likely erroring on the side of caution. When there is extreme breast sag, the concern is losing blood supply to the nipple when doing the lift. Performing only the lift at first allows the breasts to heal without additional strain on them. Without any of us on this forum seeing your breasts, we can't tell you which surgeon to go with because it wouldn't be an informed opinion.

Published on Jul 11, 2012

If they both showed you cases like yours with beautiful results, they are each telling you this is the way they can get you that result. Both approaches are acceptable.

Who did you like better? If they had offered you the same approach, who would you choose? Questions like these will help you come to a conclusion on who you want to perform your procedure.

Published on Jul 11, 2012

Two highly qualified surgeons don't have to agree as to what is best any more than two great hair dressers or two interior decorators as to what is going to make your hair/home look fabulous. The surgeons are weighing what works best in their experience, maximizing the benefits and minimizing risks and re-dos. If you must, see other board-certified plastic surgeons in consultation. But in the end, it is not an exact science and the patient has to go with a level of confidence that she finds reasonable after discussion the pros and cons of a combined vs. staged procedures. Look at his photos of the result and make sure that you are OK with the possible results, the costs, and the schedule from beginning to completion.

Published on Jul 11, 2012

It's hard to say. Perhaps if you get references and look at pics you'll be in a better position to decide. But, overall, staging is safer and gives more latitude in choosing implant size if you wait at least 6 mos.

Published on Jul 11, 2012

Excellent question. A two-stage procedure is much more simpler than a one-stage procedure and usually gives better results. Pexy-Aug is one of the most complicated procedures a plastic surgeon does. If you want to go "large," then a two-stage procedure is for you. Other determining factors include: your frame, the amount of breast tissue, amount of sagging and the size implant you want to place.

Personally, for over 30 years, I do a one-stage procedure. For the most part, I feel that my patients are happy. There is no right/wrong answer; you have to make the decision based on "gut." Ask to see photographs of each surgeon's work to help you make the decision. Best of luck.

Published on Jul 11, 2012

Mastopexy augmentation is a very challenging procedure, and there are many variables to consider. It is common to get multiple different opinions, and it may take a second visit with both plastic surgeons and/or another consult with a third plastic surgeon experienced in mastopexy augmentation.

Published on Jul 11, 2012

The question you ask has no correct answer. The risk of healing problems is less with two separate surgeries; however, there are added risks to having two surgeries. I think a third doc might break the tie, or better yet go with the doc you trust the most. .

Published on Jul 11, 2012

The choice is yours. I believe it is fair to ask the first surgeon what she or he thinks of the second surgeon's opinion. Generally, I would perform both procedures in the same surgery time. I think it is of utmost importance that you are completely comfortable with your surgery.

Published on Jul 11, 2012

Thanks for your question. Some surgeons, such as Dr. Stein, will do both procedures at the same time. The incision, and resulting small scar, would be areolar.

Published on Jul 11, 2012

Both are correct, however, as a Cosmetic Surgeon, staging the operation may help you with a happier recovery.

Published on Jul 11, 2012

Some surgeons do not feel comfortable performing a lift with an augmentation - it is a technically demanding operation. I would ask to see as many pre and post op photos from both surgeons and evaluate their results - if the one stage surgeon is getting great results as seen on his/her photos- that would be a reasonable way to decide.

I hope this helps

Published on Jul 11, 2012

Doing a lift and augmentation at the same time is more risky, but can be done successfully by someone with experience. Without seeing photos, I cant really tell you what I would do in your case but unless you have significant sagging and minimal breast tissue, I would probably tell you its ok to do them both at once. There is nothing wrong with doing it in stages, but that does mean 2 surgeries, 2 recovery periods, and probably more expense. Best of luck.

Published on Jul 11, 2012

The bigger the lift needed, the harder it is to control all the variables during surgery. The two surgeries (breast augmentation and breast lift) are diametrically opposed to each other. One is trying to make you higher and tighter, while the other is trying to make you larger and fuller. If there is a significant amount of skin to remove and tailor, this makes shaping around the implant more difficult. Most plastic surgeons have a threshold that they do not like to cross when it comes to doing them at the same time. There can be a pretty high revision rate with a single stage augmentation mastopexy if the lift is a big one. It is easier to control everything with a lift first (getting the breast architecture in place) and then doing the augmentation ( shaping and adding volume). In your case, you have to go with the surgeon you felt most comfortable with.

Published on Jul 11, 2012

As surgeons, we give our recommendations based upon our experience. I respect both of those opinions and yet I have a different opinion. I probably would place an implant and perform a vertical lift and NOT perform an anchor lift. In my opinion the anchor lift flattens the breast and places too much scar on the breast

Published on Jul 11, 2012

I congratulate you on seeking the advice of board-certified plastic surgeons! I recommend that you look at their before and after results of each to see their work and results. Taking a look at patients who were similar to you may help better determine who works best for you. It certainly doesn't hurt to try for a third opinion, but I feel that in most cases it is safe to do an augmentation and mastopexy and even the most severe of cases of drooping.

Published on Jul 11, 2012