It is often very difficult for women to know whether they need a breast enlargement or whether they in fact need a breast lift. As a general rule if the problem is breast size only, then the use of a breast implant alone may be appropriate. However if breast shape is the real problem, particularly if it is associated with a low nipple position, then it is more likely that some kind of breast lift procedure is required – either alone or combined with the use of a breast implant.

Occasionally, in cases of mild breast droop or ptosis a teardrop implant can correct all three elements – breast size, breast shape and nipple position.

There are also times when a breast lift alone, while correcting the breast shape and nipple position, will not give the desired increase in breast size. In such cases an implant will be added to increase size – known as an augmentation mastopexy.

This is the most difficult area in breast surgery and requires careful assessment and planning. It is helpful before you have seen Dr Stradwick to have considered which of the three key elements require improvement – breast shape, nipple position or breast size.

The answer is maybe. About a third of women can’t breastfeed anyway and another third have difficulty. Only 30% of women find breastfeeding a straight forward process. There is no evidence that breast surgery affects these statistics. If you breastfed prior to a breast lift or breast reduction then it would be expected that this would be possible afterwards. However, Dr Stradwick would generally advise women who are considering having more children and particularly if they are planning to breastfeed to wait before having a breast lift. The breast engorgement that occurs during pregnancy and lactation would almost certainly change the results of surgery leading to the skin stretching and the breast sagging again.

The answer unfortunately is yes. Although the clock can be wound back it still keeps ticking. As we age the skin of the breasts loses elasticity and stretches over time. This is a slow process however. Any kind of lift procedure whether it is facelift, browlift or breast lift should be viewed as a resetting of the clock – not a stopping of the clock.

Because a significant proportion of the breast is fat any weight gain will usually translate into an enlargement of the breasts. Adding weight to the breast can be expected to accelerate the process of stretching.

For the same reasons weight gain is detrimental to the result of breast lift, adding a breast implant at the same time as a breast lift definitely reduces the longevity of the result. In fact that procedure – a simultaneous breast lift and the placement of weight in the breast in the form of a breast implant seems illogical. That is because it is illogical. On the one hand the surgeon is trying to elevate the breast as much as possible but at the same time he is adding weight that will stretch the breast.

There are techniques used to try and overcome this problem – trying to use a small textured breast implant for instance. However, the best way of achieving a long- standing result in these cases is to use a 2 stage approach. Perform a breast lift first to get the shape and nipple position right. The breast augmentation is then performed 6 months later once the result of the breast lift is stable. For obvious reasons women usually prefer just one operation; having the breast lift and breast implant performed simultaneously - however this is always at the expense of a long lasting result.