Augmentation mastopexy carries the general risks of any operation, such as bleeding, infection, blood clots and anaesthetic complications, together with the combined risks of a breast lift and implants. These include delayed wound healing, changes in nipple sensation or blood supply, asymmetry, recurrent droop, capsular contracture and the possibility of revision surgery. Because two procedures are performed together, the chance of needing a further operation is higher than for either alone.
Why the combination is more demanding
A breast lift removes skin and tightens the envelope, while an implant adds volume that pushes outwards. These two forces work in opposite directions, and the surgeon must balance them so that the skin closes without excessive tension and the nipple keeps a good blood supply. Choosing a sensible implant size and a suitable lift pattern is one of the most important safety decisions, which is why Mr Nassab may recommend a more modest implant than a patient first imagines.
General surgical risks
- Bleeding (haematoma): a collection of blood that usually appears in the first day or two and may need a return to theatre.
- Infection: may affect the wound or, less commonly, the implant pocket; an infected implant sometimes needs removing.
- Blood clots: deep vein thrombosis or pulmonary embolism, reduced with compression stockings, early walking and assessment of individual risk.
- Anaesthetic complications: minimised by pre-operative assessment and monitoring by a consultant anaesthetist.
Risks specific to a lift with implants
- Wound healing problems: small areas of separation, often where incisions meet under the breast, are relatively common and usually heal with dressings.
- Nipple and areola changes: reduced, heightened or lost sensation; rarely, partial or complete loss of nipple tissue due to reduced blood supply.
- Asymmetry: breasts are naturally different, and some difference in shape, size or nipple position may persist.
- Recurrent droop: the breast tissue can descend again over time, especially with larger implants, weight change or pregnancy.
- Capsular contracture: tightening of the scar capsule around the implant, which can cause firmness, distortion or discomfort.
- Implant-related issues: rupture, rippling, malposition and the need for future replacement.
- Scarring: anchor, lollipop or circular scars that can stretch, thicken or become darker; see the scars guide.
- Breastfeeding: the ability to breastfeed may be affected.
Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL), a rare condition associated mainly with textured implants, and breast implant illness are discussed openly at consultation.
How risks are reduced
Careful assessment comes first. Smoking and nicotine products markedly impair wound healing, so you will be asked to stop for at least six weeks before and after surgery. Mr Nassab will review your medical history, weight stability and breast tissue quality, and may advise a staged approach if a single operation would put the skin or nipple under too much strain. In theatre, meticulous technique, antibiotic protocols and careful implant handling help reduce infection and contracture. Afterwards, a supportive bra, regular reviews and prompt management of any wound issues all play a role.
Normal healing versus a problem
Expected findings include swelling, bruising, tightness, breasts that sit high and look squared off, temporary numbness, some asymmetry while swelling settles, and small scabs along the incisions. It is also common for one side to feel different from the other for several weeks. What is not normal is one breast swelling rapidly, persistent heat or redness, increasing discharge, or a wound opening widely.
When to seek help
Contact the surgical team urgently if one breast rapidly swells or becomes tense and painful, or if the nipple turns dark or purple. Call the team the same day for a fever, spreading redness or discharge. A sudden, one-sided calf swelling or pain requires a same-day GP visit or NHS 111. If you experience chest pain or breathlessness, call 999.
Long-term considerations
Implants are not lifetime devices, and many patients will need further surgery at some stage, whether to replace implants, adjust the lift or treat contracture. Regular breast awareness and attending routine breast screening when invited remain important. The revision guide explains what further surgery can involve.
Frequently Asked Questions
Is augmentation mastopexy riskier than an augmentation alone?
The combined procedure has a higher chance of wound healing problems and revision, because lifting and enlarging the breast at the same time increases the demands on the skin and tissues.
Can the breasts droop again after surgery?
Yes, some descent is expected over time. Weight stability, a sensible implant size and supportive bras can help the result last longer.
Is loss of nipple sensation permanent?
Most changes improve over months, but a permanent change in sensation is possible and is discussed before surgery.
Does smoking really matter?
Yes. Smoking and nicotine reduce blood flow to the skin and nipple and significantly increase the risk of wound breakdown.
Would a staged operation be safer?
For some patients with very lax skin or significant droop, performing the lift and augmentation separately may be safer. Mr Nassab will advise on the best approach for you.
