2026

Many women considering breast surgery feel confused about whether they need a breast lift, implants, or a combination of both. While implants add volume, they do not always address sagging, and a lift improves position without increasing size.

In this video, Dr. Dimitri Koumanis clearly explains the difference between breast lifts and breast implants and how to determine which option fits your concerns and goals. Understanding what each procedure does can make the decision process much clearer. The full transcription of the video is included below.

Video Transcription

If you’re unhappy with the appearance of your breasts and you’re considering surgery, one of the most confusing questions is this. Do I need a breast lift, implants, or both? Many women assume implants will fix everything, but that’s not always the case. Today, I want to explain the difference clearly so you can understand which option is right for your body.

I’m Dr. Dimitri Koumanis at Saratoga Springs Plastic Surgery, and this is one of the most common conversations I have in consultation. Once patients understand what each procedure actually does, the decision becomes much easier.

Breast implants are designed to add volume. They increase fullness and can enhance cleavage. However, implants do not lift the breast tissue or reposition the nipple. If your breasts sit higher on the chest and you mainly want more size or fullness, implants alone may be all you need.

What a breast lift actually does is a breast lift is a mastopexy, which reshapes the breast by removing excess skin and repositioning the nipple higher on the chest. A lift improves shape and position not size. It can make the breasts look perkier and more youthful, but it does not add volume unless combined with an implant.

So, how do you tell which one you might need? A simple way to think about it is this. If your main concern is size, implants may be enough. If your main concern is sagging, drooping, or nipples pointing downward, a lift is likely needed. If you want both more volume and a higher perkier shape, then the lift with breast implants is often the best solution.

Why implants alone sometimes disappoint patients. One of the most common reasons patients are unhappy after surgery is when implants are used to mask sagging. While an implant can fill loose skin, it doesn’t correct the underlying droop, and over time, gravity can make the result worse. In these cases, combining a lift with an implant creates a more stable and longer-lasting result.

So, why do some women not need an implant at all? Not every patient wants to be larger. Some women are happy with their volume, but want their breasts to look firmer, higher, and more youthful. For those patients, a breast lift alone can be incredibly transformative.

There’s no one-size-fits-all answer. Your anatomy, skin quality, lifestyle, and goals all matter. A good consultation focuses on evaluating your breast position, tissue support, and expectations, not just implant size.

So, if you are considering breast augmentation, please come and see me at Saratoga Springs Plastic Surgery. I’m Dr. Dimitri Koumanis, and our number is 518-583-4019 or saratogaspringsplasticsurgery.com.