Breast augmentation involves the placement of an implant to enlarge the breast. However, breast augmentation does not change the shape of the breast. If the breast shape has changed with gravity, time, or pregnancy, a breast lift (mastopexy) may be needed to restore the shape of the breast. This would involve additional incisions to raise the position of the nipple and remove some of the extra skin on the breast. A simple way to determine whether a breast lift would be needed is to examine the position of the nipple relative to the breast crease (where the breast meets the chest wall – where the underwire would sit). If the nipple is below this line, then a breast lift (mastopexy) might be needed. If the nipple sits above this line, then it is likely only an implant would be needed.A breast lift with an implant, also known as an augmentation-mastopexy, can be performed at the same time in good candidates. This would involve one trip to the operating room where both an implant is placed under the muscle and the breast shape is adjusted by lifting the nipple and removing any excess and damaged skin. Only a consultation with a board certified plastic surgeon could tell you if this would be the best option for you.