Breast augmentation combined with breast lift. Some women desire a change in both the size and shape of their breasts. Many of these women have had atrophy and sagging of the breast following childbearing and breast feeding or have lost a substantial amount of weight. There are also some developmental abnormalities of the breast that can result in a small and saggy breast in a young woman. A breast lift combined with a breast augmentation can usually restore the fullness and shape of the breasts. Breast implants can be placed at the same time as a breast lift and through the breast lift incision. Patients who have a lot of extra skin and resultant sagging of the breast usually need a full breast lift which leaves scars aound the nipple and under the breast. Patients with just a little sagging can often be treated with just a periareolar lift which leaves a scar just around the aerola. Occasionally, very mild sagging can be corrected with a special shape of implant. I would determine which operation would be best for you during the initial consultation. I perform this type of surgery at Seattle Surgery Center which is located in my building on First Hill in Seattle. The surgery takes from 2 to 4 hours depending on the degree of lifting gone. The surgery is done as an outpatient. Most patients take 1 or 2 weeks off of work following this type of surgery and return to most normal activities within a month. The scars can take up to 1 year to settle down. Insurance does not cover this type of surgery unless it is being done for a developmental abnormality or to help with symmetry following breast reconstruction surgery following mastectomy.