Berman Blog - Breast Augmentation or Breast Lift: Which One is Right for Me

Breast Augmentation or Breast Lift: Which One is Right for Me?

This is an extremely common question and a good one. The answer really depends on where your nipple-areolar complex (NAC) lies relative to where your breast meets the chest wall when viewed from the side (lateral view).

If your nipple is positioned at or above the crease, when viewed from both the front and side, then you probably do not need any type of lift.
If it is just at the crease, then you may need a lift in order to achieve your desired result.

If the nipple is at the bottom of your breast and it points to the floor, you’ll likely want a breast lift for a more balanced shape.

The question of whether or not get an augmentation is really a question of, “do you want more volume, i.e. larger breasts?” For the most part, a beast augmentation makes the breasts larger, but does not really change the position of the NAC on the breast. The lift alters the position of the NAC, but does not change the volume – though it is true that a lift can sometimes make the breast look larger since it is less droopy.

Of course, many women want and need both an augmentation and a lift to get their desired look, and these can be done at the same time. It is important to note that it is always a more predictable outcome for the final shape if a woman only requires a straightforward augmentation, than when we perform a combination of an augmentation and a lift. This is especially true for one of the more complicated lifts, such as a vertical mastopexy.

Have additional questions? Please do not hesitate to schedule a complimentary, private consultation with me to discuss your individual needs.

Berman Cosmetic Surgery Blog - The Evolution of Breast Implants

The Evolution of Breast Implants

Let me first note that is  meant as a guide and not a historical thesis. However, I could not resist adding the paragraph below from Wikipedia:

From the first half of the twentieth century, physicians used other substances as breast implant fillers—ivory, glass balls, ground rubber, ox cartilage, Terylene wool, gutta-percha, Dicora, polyethylene chips, Ivalon (polyvinyl alcohol—formaldehyde polymer sponge), a polyethylene sac with Ivalon, polyether foam sponge (Etheron), polyethylene tape (Polystan) strips wound into a ball, polyester (polyurethane foam sponge) Silastic rubber, and teflon-silicone prostheses.

The first “breast filler” surgery took place in 1895, and involved fat being transferred to the breast.The main thing to note is that today, we largely have only saline and silicone implants. There has been a variety of different fill substances and coatings. but those have largely been discarded due to a variety of problems.

What has changed is that there are two basic coverings for the implants: smooth and textured (small spikes or velcro-like). Also, there now are options in the profile of the implant. This means that the base diameter gets smaller as the implant projects more forward. Over time, the options in this area have increased considerably. Although there are certainly instances where it is helpful to have a smaller base diameter and to have an implant that projects more prominently, I often feel that there are variations between each model. When it is only measured in millimeters, it is driven more by a marketing desire (so a woman can feel that she is more in control) than of any practical reasoning. In my opinion, one cannot possibly notice difference of this small amount.

The other big change is in the “cohesiveness” of the silicone implant. This means that the silicone implant gets firmer – and subsequently, more expensive. This could be beneficial for the woman with very thin skin and soft tissue so that it is less likely to show rippling. In general, the greater the cohesiveness and firmness, the more the company is charging for the implant. But again, depending on the skin condition, that may be the more desirable option, if you’re already taking the time and effort to improve your appearance in this area.

The good thing is that we now have implants that we believe to be both safe and effective, and with a variety of options, so that everyone should be able to find an implant that will be effective for them and give them their desired end result.

Are Breast Augmentations Still Taboo?

The quick answer is NO!

In the United States alone, there are literally millions of women who have had a breast augmentation. Based on the sheer number of women getting the procedure, we can clearly concur that it is not taboo. From young women wanting to look a little fuller, to weight loss success stories, mothers and grandmothers looking to get their lift back, there are no limits to age and circumstance of women getting this popular procedure done.

There is also a shift I’m seeing, especially in the past few years. Women are feeling much more comfortable being open about having had this surgery. I suspect that social media has helped to create this culture of authenticity and openness. There have been endless articles written in popular magazines available everywhere. There are a plethora of videos featuring them – both medically and for entertainment purposes. Many models and athletes have augmented their breast size – and have been very open about that fact.

There are also some changes in implants. They are  getting more and more natural to the touch since silicone implants re-entered the market in 2006. Numerous medical studies were done between 1992-2006 confirming that there appear to be no additional medical risks from silicone implants. The public is also realizing that there is no need to change out your breast implants after 10 years, provided they feel and look good. I have seen a large number of women who have had their implants in much longer than 15 years with no problems. I have a number of women I placed breast implants in over 15 years ago who are doing great. I personally have seen two patients who have kept their same implants from the 1970’s! (Note: I did not perform those procedures – I’m not quite that old.)

I also believe that society has finally realized that while you can diet and exercise all you want, if you want larger breasts or a little lift, the only way to get that is with a breast augmentation. As cosmetic procedures have become safer and safer, we are allowing people to fearlessly, and unapologetically, make changes to their bodies as they see fit. We can change our clothes and we can make changes to our bodies – and remain the same person. We have not sold ourselves out- but rather, we have had the strength in our convictions to get what we want, when it has not been handed to us.

If you are considering a breast augmentation yourself, please do not hesitate to call my my office at 703-406-2444 to schedule a private, complimentary consultation or click here to book online.

Is a Mommy Makeover Right for You?

It’s important to understand that a Mommy Makeover is not a specific set of operative procedures. It refers to the surgery one might undergo after having a baby. Most commonly, it involves having a tummy tuck and a breast augmentation with or without a breast lift. However, it could refer to just one of these procedures or could include SmartLipo, a mini Tummy Tuck or a breast lift.

There is no way I can help you determine via a blog post whether or not a specific surgery is right for you. You really need to visit a board-certified plastic surgeon for a  personal consultation (note: a “cosmetic surgeon” is NOT a plastic surgeon – there is no Board certification for this).  

Having said that, there are some considerations you can take into account to determine if a Mommy Makeover might be right for you: 


If you are thinking of a Tummy Tuck:

  • Have you allowed enough time since delivery or C-section to see how much the skin will tighten on its own?
  • Have you lost all of the weight that you think you are going to lose? You don’t have to get down the very last pound, but all things being equal, it is better if you have lost most of the weight you are planning to lose.
  • Are you planning on having another child any time soon? If you know you are going to have another child in the next 1-2 years, you may want to hold off doing your TT until you are finished having babies and instead just go for SmartLipo. However, if having another child is just a remote possibility, then this is something that should be discussed with your plastic surgeon. Often in this case, I will perform the tummy tuck, but not tighten the fascia.


If you are thinking of a Breast Augmentation:

  • Are you still breast feeding? You should hold off until at least 3 months after you have stopped breastfeeding and your milk has dried up. You should also wait until your breast size has stabilized after you stop breastfeeding.
  • A breast augmentation will not prevent you from breastfeeding in the future, nor will it interfere with sensation.
  • Sometimes, only a breast lift is required – and depending on what type of lift, it may be able to be carried out in the office under local anesthetic with just oral sedation (i.e. a donut mastopexy).


What about doing the Breast Augmentation and Tummy Tuck in the same surgical procedure?

  • These procedures are often  done together in the same surgery and it works out very nicely. The advantage of this approach is that it allows you to recover from both at once, meaning less days off of work.  Most people should be able to return to work in 2 weeks (some will go back in 10 days). There are also cost savings when doing both at once. 
  • It should be noted that there is a higher risk of Deep vein thrombosis, or DVT. However, I put my patients that have both procedures on Lovenox after surgery and I get them up walking immediately, which significantly decreases any risk of DVT and pulmonary embolus.
  • It does take a few days longer to bounce back from the combined procedure than it would from either procedure alone.

If you have any questions, I highly recommend calling my office at 703-406-2444 to schedule a private consultation with me.

Breast Feeding After a Breast Augmentation

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 Is Breast Feeding Appropriate After Having a Breast Augmentation?

Whether or not one can engage in breast feeding after a breast augmentation is one of the most commonly asked questions for patients considering the procedure. The basic answer is YES.  It is very unlikely that a breast augmentation will interfere with your ability to breast feed.  The reason is that even if a periareolar or inframammary incision is used, it is unlikely that the ducts from the milk glands will be cut.

It is important to know that approximately 10% of all women will have trouble breastfeeding, so if you have trouble breast feeding, it is probably NOT due to having had a breast augmentation.

What About Breast Feeding After A Breast Lift?

The answer can be a bit more complicated with an associated breast lift.  A donut mastopexy, because it is just removing skin and sliding the nipple areolar complex upwards, is very, very unlikely to interfere with breastfeeding.

The vertical mastopexy, because it is re-arranging the breast architecture, has some small probability of interfering with breastfeeding but I think this is fairly unlikely as well.

Thinking about a breast augmentation or breast lift? Please contact us to schedule a complimentary consultation with Dr. Berman. He’ll address any questions or concerns you may have about the procedure.

And be sure to check out our videos below for a look inside the procedure as well as some information from Dr. Berman on things to consider when getting a breast augmentation.

You can also check out this video testimonial from one our recent breast augmentation patients![/vc_column_text][/vc_column][/vc_row][vc_row type=”in_container” scene_position=”center” text_color=”dark” text_align=”left” overlay_strength=”0.3″][vc_column column_padding=”no-extra-padding” column_padding_position=”all” background_color_opacity=”1″ background_hover_color_opacity=”1″ width=”1/1″][vc_text_separator title=”Breast Augmentation Videos”][/vc_column][/vc_row][vc_row type=”in_container” scene_position=”center” text_color=”dark” text_align=”left” overlay_strength=”0.3″][vc_column column_padding=”no-extra-padding” column_padding_position=”all” background_color_opacity=”1″ background_hover_color_opacity=”1″ width=”1/2″][vc_video link=”″][/vc_column][vc_column column_padding=”no-extra-padding” column_padding_position=”all” background_color_opacity=”1″ background_hover_color_opacity=”1″ width=”1/2″][vc_video link=””][/vc_column][/vc_row]