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Breast augmentation and lift

If you have sagging breasts, not enough volume, and drooping nipples and want fuller, rounder breasts and a more youthful contour, you're a good candidate for a breast lift combined with a breast augmentation

Facts about breast augmentation and lift

With breasts that are only slightly sagging, a normal breast augmentation may be sufficient to lift your breasts. But patients with severely sagging breasts in combination with excess skin will benefit far more from a combination of breast augmentation and a breast lift: an average implant weighs 250 grams and will weigh the breasts down even more unless they are lifted and excess skin is removed. A natural-looking contour of the breasts is achieved by adding volume to the breast above the nipple. Combined breast augmentation and breast lift surgeries are also often performed on women who have lost a lot of weight due to gastric bypass or gastric banding surgery.

Improved procedure

As a rule, breast augmentation with lift surgeries used to mean two separate operations: first, the lift and, at a later stage, breast augmentation. Nowadays, these procedures are performed in one single operation — the results are often even better than with a phased approach because less skin needs to be removed and, consequently, less scarring. In addition, research has shown that there is no greater risk of complications if the procedures are combined. Naturally, it is preferable for patients to undergo one operation instead of two.


Dr Pirayesh works exclusively with breast implants from Mentor, the safest silicone implants on the market, with a lifetime replacement warranty against rupture. In case you are reluctant about silicone implants because of the negative stories you have seen online and on TV, it’s good to know two things:

  1. Stories about leaking and rupturing implants involve (old) liquid silicone implants. Mentor breast implants are filled with a viscous silicone gel, which is as thick as a young cheese. Therefore, even after severe trauma to the chest area, the contents of Mentor implants will stay put and can be easily removed by surgery. An analogy to clarify: if a car window broke twenty years ago, the inside of the car would be covered in glass fragments, whereas modern cars have a protective film installed on the windows, so if they should break, they will not shatter – which is much safer.

  2. The US National Cancer Institute has launched extensive scientific studies that concluded that women with silicone implants are not at a greater health risk than those without implants. There was also no association with any diseases, such as rheumatoid arthritis. However, implants make breast health screenings, such as mammography, a little more complicated. If you have a mammogram or other diagnostic test on the breast, it is essential to let X-ray staff know that you have implants in place so that the most appropriate screening method is used.

Breast augmentation and lift overview and timeline

Duration of the operation: 2 to 3 hours
Anaesthesia: light general anaesthetic administered by a specialised anaesthetist
Length of stay: outpatient, you can return home about 4 hours after surgery. You need to arrange transportation because you cannot drive yourself home.
Post-operation: slight swelling and tenderness. We will give you a sports bra that you have to wear, painkillers, antibiotics, and instructions on wound care.
Complications: very rare: fluid retention, infections, raised, livid scars
Recovery time: You may resume your normal activities one week after surgery, but you must refrain from lifting anything heavier than 5 kilos for the first two weeks and no heavier than 10 kilos for the next four weeks.
Results: modern, safe implants will ensure you will enjoy the effects of your breast augmentation for ten years or more. Because your body will continue to age and change, you may, in time, require replacement of the implants or a breast lift surgery.
Scarring: The stitches will be removed within a week, and your scars will fade after a few months. Dr Pirayesh has developed a program, APS Scar Care, including aloe vera-based creams, laser treatments, and (if necessary) injections to ensure that your scars heal in the best possible way.

Breast augmentation and lift surgery in six steps

On the day of your surgery, Dr Pirayesh will mark your breasts while standing so that the current size and position of your breasts and nipples can be determined when you are lying on the surgery table. In addition, photos will be taken for your medical record.

Step 1. Anaesthesia

A specialist anaesthetist will inject a light general anaesthetic into a vein through a cannula (a thin, plastic tube) in your arm or hand. The anaesthetist and his team will monitor you closely throughout the operation, ensuring you are comfortable and safe. The anaesthetist will discuss the anaesthesia before your surgery and answer any questions.

Step 2. Placing the implants

Dr Pirayesh makes incisions that he previously agreed with you and places the implants in your breasts. You will then be placed in an upright position. This ensures that the implants are symmetrical and in the correct position. During the consultation, Dr Pirayesh explained whether your implants would be placed in front, behind, or half behind the pectoral muscle (dual plane technique) for best results. Dr Pirayesh will use multiple inserts to ascertain the optimum implant size, after which the definitive implants will be placed.

Step 3. Breast lift
  • When the implants are correctly positioned, Dr Pirayesh commences with the breast lift

  • The underlying breast tissue is lifted and re-shaped to enhance the contour and firmness of the breasts

  • The nipple and areola are repositioned to a more natural, more youthful height

  • If necessary, enlarged areolas will be reduced and reshaped

  • Excess skin is removed to compensate for a reduced elasticity

Step 4. Suturing and bandaging

When Dr Pirayesh is happy with your new breast contours, he will suture the incisions. The incisions remain hidden in the natural fold under your breasts. They will significantly fade over time. The stitches are made in the deeper layers of breast tissue and support the newly formed breasts. Dr Pirayesh used sutures and/or surgical tape to seal the skin and protect the wounds. A small drain may be inserted under the skin to drain excess blood or fluid. The results of your breast augmentation and lift are immediately visible.

Step 5. Recovery and aftercare

​Dr Pirayesh provides specific written instructions about how to take care of your breasts in the weeks after surgery and the medication you should use for optimal healing and minimal risk of infection. When you come to the clinic for follow-up appointments, you will meet with him to discuss details with him and ask questions. Within a week after the operation, he will check the incisions and remove your sutures. After some time, the swelling will subside, and the scars will fade. If you have questions, Dr Pirayesh will happily answer them via WhatsApp. Avoid the solarium or sauna for ten days before and ten days after surgery, and don’t drink alcohol or take blood thinners like aspirin (paracetamol is allowed).

Step 6. Wound healing and scars

​Dr Pirayesh is very savvy when it comes to promoting rapid healing. He has developed a customised regimen, APS Scar Care, including creams based on aloe vera, laser treatments, and (if necessary) injections to ensure that your scars heal in the best possible way.

This regimen has ensured that many of Dr Pirayesh’s patients have hardly noticeable scars. However, it is impossible to pre-determine if patients will have problems with their scars healing.

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