Two different problems often arrive together. Volume has gone, usually after pregnancy, breastfeeding, or weight change, and the breast has also dropped so that what volume remains sits lower than it once did. An implant alone fills the first problem and can make the second more obvious.
At Summit Plastic Surgery in Redding, CA, Dr. Max Malotky performs augmentation with mastopexy as a combined procedure addressing both. It is a more involved operation than either alone, and this page is written to explain what that actually means rather than to make it sound simpler than it is.
Mastopexy is the surgical term for a breast lift. It removes excess skin, reshapes the remaining tissue, and repositions the nipple higher on the breast. Augmentation adds volume with an implant. Performed together, the two address deflation and drooping in a single operation and a single recovery.
The combination is genuinely common after pregnancy and breastfeeding, and after significant weight loss, because both tend to produce the same pair of changes. Volume decreases, and the skin envelope stays stretched, so the breast has both less to fill it and more skin to fill.
It is worth understanding that combining them is not simply doing two things at once. Adding volume pushes outward while lifting tightens inward, and balancing those two forces in one operation is the part that requires judgment. That is also why the combined procedure carries a higher revision rate than either performed alone.
This is the question most patients arrive with. There is a straightforward clinical test for it, and your surgeon will use it at consultation rather than asking what you think you need.
You do not need to work this out in advance. What you should expect from a consultation is a clear explanation of which category you fall into and why, based on measurements taken rather than on what you asked for when you booked.
The combined procedure achieves something neither operation delivers alone. That is the reason it exists despite being more involved than either, and it is why most patients with both concerns choose it.
The operation is performed under general anesthesia in an accredited surgical facility and takes approximately three to four hours. Both components are carried out in a single session.
Incisions are placed to allow both implant placement and skin removal, typically around the areola and vertically down to the breast crease, with a horizontal extension along the crease where more skin needs removing. The implant is positioned, excess skin is excised, the tissue is reshaped, and the nipple is repositioned higher. Areola size is reduced at the same time where it has stretched.
Implant selection is decided with you before surgery, covering size, profile, and placement above or beneath the muscle. Those choices affect both the result and how the breast behaves over time, so they are worth spending consultation time on rather than deciding quickly.
The procedure reshapes the breast as a whole rather than adding volume to what is already there. Each element below is considered during planning.
Restored with an implant selected for your frame and your goals.
Rebuilding fullness in the upper portion, which is the change most patients describe first.
Reshaped and supported so the breast sits correctly on the chest wall.
Repositioned higher to sit naturally on the lifted breast.
Reduced and repositioned where stretching has occurred.
Excess skin removed and the remainder redraped over the reshaped tissue.
The crease beneath the breast, often repositioned as part of reshaping.
Shaped to create proportion and symmetry between the two sides.
Differences between the two breasts addressed as part of the surgical plan.
Most patients arrive with several of these together. That combination is generally what indicates the full procedure rather than one component alone.
Good candidates have both volume loss and drooping, are in good general health, and are at a stable weight. Weight change after surgery affects the result, so patients still working toward a target are usually better treated once they get there.
Being finished having children matters more here than with many procedures, because pregnancy and breastfeeding produce exactly the changes this operation corrects. It is not an absolute requirement, but it directly affects how long your result holds.
Realistic expectations about scarring are essential. This procedure leaves more scarring than augmentation alone, permanently, and patients who understand that before surgery are consistently the most satisfied afterward. Smoking must be stopped well in advance, as it significantly increases the risk of wound healing problems in this operation specifically.
Your full history, current medications, and existing conditions are reviewed by Dr. Malotky at consultation before surgery is scheduled.
Breast augmentation with mastopexy leaves permanent scars, and more of them than augmentation alone. That is the central trade-off in this procedure, and no page that skips over it is being useful to you.
A lollipop pattern places incisions around the areola and vertically down to the breast crease. An anchor pattern adds a horizontal incision along the crease itself and is used where more skin needs removing. Which applies to you depends on how much lift is required, and Dr. Malotky will show you the pattern for your case at consultation rather than afterward.
Scars are most noticeable in the first months, then fade and flatten over a year or more. They are positioned to sit within a bra or swimsuit. Scar care makes a genuine difference to the final appearance, and you will be given specific guidance.
You go home the same day with a supportive surgical bra. The first few days involve soreness and tightness rather than sharp pain, and most patients describe it as more manageable than they expected.
Patients considering this operation are often weighing it against one of its components. Others are planning it alongside body procedures, particularly after pregnancy or weight loss.
This is a technically demanding operation with a higher revision rate than either of its components alone. Who performs it, and how carefully they plan it, matters more here than on most procedures.
The combined procedure is quoted as a single figure covering the surgeon’s fee, anesthesia, the facility, and your implants. Because implant choice and the extent of lift both affect it, the quote is given after your consultation rather than as a published price.
It costs more than either component alone but less than the two performed separately. You are paying for one anesthetic and one facility session rather than two, which is a meaningful part of the total.
Summit Plastic Surgery is located on Buenaventura Boulevard in Redding, CA. We see patients from across Northern California and the greater Sacramento area, with many traveling from the communities listed below.
The clinical test is where your nipple sits relative to the crease beneath your breast. At or above that crease, an implant alone will usually give you the result you want. Below it, an implant alone tends to make the drop more noticeable rather than correcting it, and a lift is needed alongside.
What you want to change matters too. If size is the only concern, augmentation alone addresses it. If position and shape have changed but volume is acceptable, a lift alone may be enough. Measurements taken at consultation determine which category applies, and you will be told plainly if the larger operation is not necessary.
A lollipop pattern places incisions around the areola and vertically down to the breast crease. An anchor pattern adds a horizontal incision along the crease and is used where more skin needs removing. Which applies depends on how much lift your breasts require.
Both patterns leave permanent scars, and more than augmentation alone. They are positioned to sit within a bra or swimsuit, are most noticeable in the first months, and fade and flatten over a year or more. Dr. Malotky will show you the pattern for your case at consultation.
Most patients have both performed in one operation. That means one anesthetic, one recovery, and a lower total cost than two separate surgeries, which is why it is the usual approach.
Staging is sometimes recommended, usually where a substantial lift is required or where a large implant is being combined with significant skin removal. Adding volume pushes outward while lifting tightens inward, and where those forces are extreme, separating them into two operations gives better control over the final result. This is a surgical judgment made at consultation based on your anatomy rather than a preference you need to arrive with.
Possibly, and it is worth planning for rather than being surprised by. Breast implants are not lifetime devices, and most people with implants will need further surgery at some point to replace or remove them.
The combined procedure also carries a higher revision rate than either component alone, because balancing volume against lift is technically demanding. Beyond implants, natural aging, weight change, and pregnancy all continue to affect the result. None of that means the operation does not work; it means this is a long-term relationship with a surgeon rather than a single transaction.
The procedure is quoted as a single figure covering the surgeon’s fee, anesthesia, the facility, and your implants. Implant choice and the extent of lift both affect it, so the quote follows your consultation rather than being published in advance.
It costs more than either component alone but less than having the two performed separately. Cherry and CareCredit payment plans are available and commonly used.
Many women do, but it cannot be guaranteed. The lift component repositions the nipple and reshapes glandular tissue, both of which can affect milk production and delivery.
If you may want to breastfeed in the future, tell Dr. Malotky at your first consultation. It affects both the technique used and the recommendation about timing, since having the procedure after you have finished having children generally produces a more durable result anyway.
Both saline and silicone implants are available, in a range of sizes, profiles and shapes. Silicone is more commonly chosen for a natural feel, while saline has advantages in certain situations.
Placement above or beneath the muscle is a separate decision that affects how the breast looks and behaves over time. Both choices are made with Dr. Malotky at consultation based on your tissue, your frame, and the result you want.
Yes, meaningfully so. Adding volume pushes tissue outward while lifting tightens it inward, and balancing those opposing forces in one operation is the technical challenge. It takes longer, involves more incisions, and carries a higher revision rate than either component performed alone.
That is not a reason to avoid it, and for most patients with both concerns it is still the right choice. It is a reason to be selective about who performs it.
Most patients return to desk-based work within one to two weeks and are cleared for unrestricted activity at about six weeks, with chest and upper body exercise last. The first few days involve soreness and tightness rather than sharp pain.
Swelling resolves and the breasts settle into their final position over three to six months, so the result at two weeks is not the result you will keep. Scars continue maturing well into the second year.
The lift and the volume both last for years, and most patients are very satisfied for a long time. What continues is natural aging, gravity, and changes in skin elasticity, alongside the fact that implants are not lifetime devices.
Weight change and pregnancy affect the result more than time alone does. Maintaining a stable weight and being finished having children are the two things that most preserve what the surgery achieves.
If you have noticed both deflation and drooping, the useful first step is finding out which procedure your anatomy actually calls for. That answer comes from measurements rather than from a brochure, and you may need less surgery than you expect.
Call 530-638-8868 or schedule a consultation at Summit Plastic Surgery, 1800 Buenaventura Blvd, Suite 200, Redding, CA 96001. We see patients from across Northern California and the greater Sacramento area.
Good candidates are in good general health, at a stable weight, and want to increase breast size or restore volume that has been lost. The most straightforward cases are patients whose breast position is good and whose concern is size alone.
There is a clinical test that determines whether augmentation on its own will give you the result you want, and it is worth understanding before your consultation. If your nipple sits at or above the crease beneath your breast, an implant alone will generally work well. If it sits below that crease, an implant alone tends to make the drop more noticeable rather than correcting it, and a lift alongside augmentation is usually recommended instead.
That distinction is made at consultation using measurements rather than assumptions, and either answer is useful. Patients who need only an implant get a shorter operation with less scarring, and patients who need both find out before surgery rather than being disappointed by the result.
Your full history, current medications, and existing conditions are reviewed by Dr. Malotky before surgery is scheduled. If augmentation is not the right procedure for what you want to achieve, you will be told what is.
