Breast Augmentation With Lift in Plano, TX

“I am so happy with my breast augmentation results! Dr. Friedman is so knowledgeable and meticulous, and he did a great job. You’ll miss out if you don’t go to him.”

- Plano, Texas Breast Augmentation Patient: Cassie

Cosmetic breast surgery offers a variety of options to improve the appearance of your breasts, your comfort, and your confidence. While many women may benefit from a breast augmentation or a breast lift, some women require both techniques to achieve their desired breast size and contour. Dr. Ronald Friedman, a well-respected, board-certified plastic surgeon in Plano, Texas, is an expert in breast augmentation, breast augmentation revision, breast lift, breast reduction, nipple reconstruction, and more.

He performs more than twice as many breast surgeries as the average plastic surgeon and strives to achieve optimal results according to your anatomy and cosmetic goals.

Contact Dr. Friedman’s Plano office to schedule your cosmetic breast surgery consultation by calling (469) 306-1774.

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Breast Augmentation With Breast Lift Before and After Photos

What are the benefits of combining breast augmentation with breast lift?

Breast augmentation with lift improves sagging and loss of volume due to pregnancy, weight loss, or aging.

Breast Augmentation/Lift Surgical Technique:

Dr. Friedman in Plano, Texas performs breast augmentation and lift surgery under general anesthesia on an outpatient basis. The procedure is performed in his AAAASF-accredited surgical facility, the West Plano Plastic Surgery Center, which is located on the campus of Texas Health Presbyterian Hospital of Plano. He strictly uses physicians—not nurses or technicians—to administer your anesthesia.

Dr. Friedman will first place the implants, preferably below muscle, through small incisions in the creases beneath the breasts. Next, incisions are placed around the nipple-areola (to elevate the nipples and reduce areolar size, if desired) and vertically along the lower breasts (to accomplish the lift). Unlike most surgeons who perform breast lifts, Dr. Friedman typically does not place an extended horizontal incision in the fold beneath the breast except in women with severe sagging. There are no incisions on the upper breast. All sutures are internal. The incisions are sealed with a tissue glue (Dermabond). There are no external stitches, staples, compression bandages, or ACE wraps. Although there are scars from surgery, they generally fade over time.

Pain is usually mild and well-controlled with prescription pain medication. Most patients return to light activities within 3 to 5 days. Lifting, pushing, and pulling over 5 pounds should be avoided for 6 weeks.

When you visit our office in Plano, Texas, we will be happy to show you what to expect from breast lift surgery. We will also show you a variety of “before and after” photos of breast lift procedures performed by Dr. Friedman. If you wish to speak to other women who have undergone breast lift with or without implants, we will be happy to provide phone numbers.

Your Plano, TX, Breast Enhancement Options

Breast Implant Options

Saline-filled breast implants are widely available for breast enlargement. Saline implants are filled with the saline salt water solution used in I.V. fluids. If a saline implant leaks, the saline contents are released and absorbed by the body within hours. Saline (salt water) is harmless to the body. Saline implants are covered with a plastic shell made of solid silicone.

Silicone gel implants were restricted by the FDA in 1992 due to concerns regarding possible side effects. They were approved by the FDA in 2006 following many years of study. There remains no conclusive evidence of a link between silicone gel and any autoimmune disease.

Unfortunately, there is no perfect breast implant.

The advantages of silicone gel include:

  1. More natural feel. Think jelly, instead of water.
  2. Reduced rippling. If you put water in a sandwich bag, you will notice ripples in the bag, just as you will in saline implants.
  3. Longer implant life span, on average.

The advantages of saline include:

  1. Lower cost. Saline implants are $1,000 to $1,500 less expensive than silicone.
  2. Smaller incisions. Dr. Friedman places saline implants through a 3 cm (just over an inch) incision and places silicone gel implants through a 4 to 5 cm incision.
  3. Lower risk of capsular contracture (scar tissue causing excessive implant firmness).
  4. Public perception that it is a “safer” implant. Because ruptures of silicone gel implants may be difficult to detect, the FDA recommends MRI evaluation of silicone implants at regular intervals (every other year) following surgery.

The bottom line: from a purely cosmetic standpoint, silicone gel may be a better implant than saline. From a medical standpoint, it is difficult to argue with the safety of a bag of salt water. In women with a reasonable amount of breast tissue and subcutaneous fat, Dr. Friedman feels that saline is a good choice. In women with minimal breast tissue, poor breast tone, and/or minimal subcutaneous fat (and therefore a greater risk for significant rippling with saline implants), silicone gel may be a good choice.

Saline or silicone gel: Which breast implants should I choose?

Breast Lift Options

  1. Vertical-only lift: performed when the breast sags, but the nipples are in good position and the areolae (pigmented skin surrounding the nipples) are not too large.
  2. Lollipop lift: vertical lift with incisions around the areolae. This is Dr. Friedman’s most frequent lift.
  3. Anchor lift: this combines a lollipop lift with extended incisions in the creases beneath the breasts. This is reserved for severe sagging of the breasts. Dr. Friedman usually performs this procedure without placing implants at the same time. (Breast implants may be placed at a later date.)

Breast Implant Options

Breast Lift Options

Are You a Candidate for Breast Augmentation With a Breast Lift?

If you are unsure whether to combine breast implants with a breast lift, ask yourself these four questions:

Are you happy with your breast position?
If you have minimal sagging and want to increase your breast size, implants may be enough to perk up your bustline. However, if you are experiencing significant drooping and your nipples are at or below the folds of your breasts, a lift will provide improved breast shape and position.

Are you happy with your breast shape?
Breast implants will provide larger, fuller breasts with more cleavage. Your breast shape will remain otherwise unchanged. If you are unhappy with your nipple positions, areolar size, breast shape, or shape asymmetry, then a lift will address these concerns.

Are you happy with your upper breast fullness?

Although a breast lift will reshape and lift the breasts, it will provide only a modest improvement in upper breast fullness. Breast implants provide a significant improvement in upper breast fullness–because implants defy gravity better than breasts.

Are you happy with your breast size?

Breast lift will not make your breasts larger and may, in fact, make your bra cup size smaller. The addition of implants will help you achieve larger breasts–or at least improved upper breast fullness and cleavage.

What are the upsides of having your implants and lift done at the same time?

  1. Reduced cost (one surgery rather than two).
  2. Reduced time off work and away from exercise (one recovery rather than two).
  3. Reduced scarring. Dr. Friedman generally avoids lengthy incisions in the folds beneath the breasts in combined augmentation/lift patients.

What are the upsides of having your implants and lift done as two separate surgeries?

  1. In women with severe sagging of the breasts, a breast lift (first) followed by breast augmentation (no sooner than 6 months later) may provide a better contour.
  2. If you are “on the fence” about augmentation with lift, then evaluating your results after one surgery (augmentation or lift) may help you decide whether to do the second procedure at a later date.

Preparing for Breast Augmentation with Lift

Before Surgery

One week before surgery

  1. Do not take aspirin-containing products, as these may increase your risk of bleeding. Use extra-strength TYLENOL® for any headaches or other minor pains.
  2. Please notify Dr. Friedman’s staff if you become sick with a fever, significant cough, etc. If necessary, your surgery can be rescheduled to a time when you are feeling better.
  3. Do not smoke at all or use a nicotine patch for at least 2 weeks (and preferably 4 weeks) prior to surgery and 4 weeks after surgery. Smoking interferes with wound healing and increases your risk for anesthetic and surgical complications.
  4. Arrange to have a relative or friend drive you home after surgery and stay with you for the evening. You cannot drive yourself home.

The evening before surgery

  1. Do not eat or drink anything for at least 8 hours prior to your scheduled surgery time.
  2. Make some jello and/or soup for after surgery. Have some juice in your refrigerator.
  3. The anesthesiologist will contact you by phone to discuss your medical history and to answer any questions.

Day of Surgery

Day of surgery: before you leave home

  1. Remember not to eat, drink, or smoke. This includes no chewing gum, mints, etc.
  2. Make sure someone is available to drive you home. Put a pillow and blanket in the car.
  3. Wear loose, comfortable clothing. Avoid heavy make-up, jewelry, or contact lenses. Please do not use any lotion, baby oil, perfume, or powder. LEAVE ALL VALUABLES AT HOME!

Day of surgery: at the facility before surgery

  1. Dr. Friedman will talk to you before surgery to answer any last-minute questions. He will place drawings on your chest to help him accurately plan your surgery.
  2. You will meet the anesthesiologist and surgical nurses.

Day of surgery: at the facility after surgery

  1. You will be taken to the recovery area to wake up after surgery. Dr. Friedman will go to the waiting room to speak to your family/friends.
  2. Approximately 1 hour later, your family can visit you. Once you are feeling well enough, you may go home.

After Surgery

At home after surgery

  1. Have someone stay with you for the first night. You may be weak and drowsy.
  2. Take the antibiotics, pain medication (as needed), and anti-nausea medicine (if needed) that Dr. Friedman has prescribed for you.
  3. Sleep with your head elevated. Sleep on your back (not your stomach or side).
  4. Keep your dressings (gauze and tape) clean and dry. Do not remove the dressings. You may shower only from the waist down. You may wish to sponge bathe.
  5. You may remove the gauze and tape over the incisions and begin light showers 4 days after surgery. Avoid immersing the breasts under water.
  6. Take at least 10 deep breaths every hour. This will help keep your lungs expanded.
  7. Do not be a couch potato. To reduce the risk of blood clots in the legs, get up and walk any time you eat or need the bathroom. While you are in bed, repeatedly flex your ankles (moving your toes up and then down) and/or have your family massage your calves.
  8. If you experience a prolonged fever (oral temperature greater than 101), contact Dr. Friedman. Feel free to call our office or to page Dr. Friedman for any other problems or concerns.

Before Surgery

Day of Surgery

After Surgery



Instructions for your first postoperative visit (about 1 week after surgery)

Activity level

  • 1 week after surgery: you may resume casual walking but must not engage in vigorous exercise that increases your blood pressure or heart rate. You may resume driving once you are off of your pain medication. Avoid freeways until you are comfortable with city driving.
  • 3 weeks after surgery: you may resume jogging (with a jog bra) or an elliptical trainer but must avoid vigorous use of your chest or arms.
  • 6 weeks after surgery: you may gradually resume exercise involving the chest and arms. Only now may you lift more than 5 pounds.

Sleeping position

  • Please sleep on your back (flat or elevated) or part way over (pillow under your shoulder and hip). Do not sleep on your side until about 3 weeks after surgery. Unless otherwise instructed by Dr. Friedman, do not sleep on your stomach until about 6 weeks after surgery.

Incision care

  • You have a layer of tissue glue to seal your incision. After this peels off (about 2 weeks after surgery), begin scar massage with MEDERMA® twice daily. MEDERMA® is available at our front desk or over-the-counter at your pharmacy. If you prefer, you may use vitamin E or aloe vera. Continue scar massage for about 3 months.

Breast exercises and bra usage

  • Your implants are high and tight, as expected. Dr. Friedman will instruct you on exercises to mobilize the implants (usually up and in) until they have softened and settled to some degree. Final settling will take about 6 months. Once you feel that the implants are no longer “way too high,” you begin use of a bra to reduce further downward settling of the implants. If you have an incision in the breast crease, you should avoid an underwire bra for at least 3 months. Even after the implants have settled, you should push them up and in about 2 to 3 minutes per week (for the rest of your life) to help keep them soft.

Water exposure

  • You may begin light showers but should avoid scrubbing your incisions. Do not immerse your breasts under water in a bathtub for 4 weeks. Avoid immersing your breasts in a pool, lake, or ocean for 6 weeks.


  • One week after surgery, you may resume use of any medications or supplements that you discontinued prior to surgery. However, for at least 3 weeks, you should avoid MOTRIN®, aspirin, and any other product that may thin your blood.


  • Do not smoke for at least 1 month (and preferably much longer) after surgery. Smoking may increase your risk of infection, lung problems following anesthesia, and wound healing problems.


  • You may tan your breasts whenever you like. However, you should avoid tanning directly over your incisions for at least 6 months. Premature tanning of the incisions may cause them to darken permanently.


  • You may resume intercourse in a non-weight bearing position (i.e., on your side) about 3 weeks after surgery. You may not bear weight on your chest for at least 6 weeks.

Dental visits

  • Avoid dental cleanings/fillings for 6 weeks, as bacteria in your gums can be transmitted to your implants via your bloodstream.

Please feel free to ask Dr. Friedman or his staff about any additional questions or concerns.


According to data submitted to the FDA by breast implant manufacturers:

  • 2% of women undergoing breast augmentation experience postoperative bleeding
  • 2% of women undergoing breast augmentation experience postoperative infection

Dr. Friedman’s numbers are:

  • 0.2% bleeding
  • 0.5% infection

According to the same data, among women undergoing breast augmentation with saline implants, 26% underwent further breast surgery within 5 years. Dr. Friedman’s 5-year reoperation rate is 8%.

Many physicians also refer patients to Dr. Friedman for breast implant revision. Dr. Friedman performs revisions to increase or decrease implant size, remove and replace deflated or ruptured implants, soften breasts that have become hard (capsular contractures), and improve breast implant position and shape.

When you visit our office, we will be happy to show you a variety of “before and after” photos of breast enlargements performed by Dr. Friedman. You will also be able to see and feel the differences between saline and silicone gel implants. If you wish to speak to other women who have undergone the procedure, we will be happy to provide phone numbers.


The average plastic surgeon performs about 30 breast augmentations each year. In contrast, Dr. Friedman performs an average of 125 augmentations annually. He has performed well over 2,000 breast augmentations.

Total surgical cost for breast enlargement with saline implants is $5,850. Dr. Friedman’s price may be about average for the Dallas, Frisco, and Plano areas. But his commitment to your care is anything but average. Look carefully at what is included in the surgical fee.




Why Choose Dr. Friedman for Your Breast Enhancement Surgery?

Dr. Friedman has earned his reputation as a leader in cosmetic breast surgery because he has nearly three decades of experience and recognizes that the patient on the operating table is always the most important patient in his practice. He insists on techniques that reduce bleeding, bruising, tissue trauma, and complication risks.

His approach requires more time during surgery, but he refuses to do any less because he is committed to providing top-level care, comfort, and surgical expertise for his patients.

Call (469) 306-1774 to schedule your Plano, Texas, breast augmentation with lift today!

Schedule a Consultation

FAQ About Combining Breast Augmentation With a Lift

  • How should I decide if a breast lift with implants is right for me?

    Review the pros and cons of this combination breast surgery to better understand if you are a good candidate. Generally, if your breasts are sagging and you want to increase their size, consider combining these procedures.

  • Will combining a breast lift with implants add to my recovery time?

    Because your recovery from each surgery will occur at the same time, little downtime will be added. However, you may have to refrain from exercise, physically demanding activity, and some chores for a bit longer. But recovering from one surgery is generally easier than recovering from two.

  • How long will a breast lift with implants last?

    Saline breast implants last an average of 10 to 15 years, and silicone gel implants last an average of 15 to 20 years. In the absence of major postoperative weight changes or pregnancy, the results of breast augmentation with lift may last well over a decade.

  • If I have very large implants placed, won’t it make my breasts perky–without the need for a lift?

    No. If your breasts sag, they will continue to sag after breast augmentation surgery. In fact, placing a very large implant—without doing a lift—may actually make your sagging worse.

  • Should I have breast implants placed above muscle or below muscle?

    Whenever feasible, Dr. Friedman recommends placement of breast implants below the pec major muscles. This is especially true in augmentation lift patients. If your breasts are already sagging, then the added weight of above-muscle implants will make your sagging worse. Placing the implants below muscle allows your muscles to act like hammocks, supporting the implants.

  • Should I have breast implants and a lift done at the same time? Or should I have two surgeries?

    Dr. Friedman performs the vast majority of augmentation/lifts at the same time. This provides one surgery and one recovery. Only if your sagging is severe will he recommend two separate procedures, usually breast lift followed (no sooner than six months later) by breast augmentation.

  • How long will a breast lift with implants last?

    Saline breast implants last an average of 10 to 15 years, and silicone gel implants last an average of 15 to 20 years. In the absence of major postoperative weight changes or pregnancy, the results of breast augmentation with lift may last well over a decade.

  • Can I combine breast augmentation/lift with other procedures?

    Dr. Friedman frequently combines breast augmentation/lift with liposuction, tummy tucks, mommy makeover procedures, and body contouring after major weight loss.

Those in the Plano and Frisco area who are interested in breast augmentation may call (469) 467-0100 to schedule a complimentary cosmetic consultation. Contact Dr. Friedman regarding your plastic surgery questions about breast augmentation procedures.

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