Breast surgery is one of the most requested plastic surgery procedures worldwide. It is not a single surgery, but rather a group of different techniques that address distinct goals: increasing volume, reducing size, or correcting breast sagging.
Making the right choice depends not only on what the patient wants, but also on her anatomy, the condition of her tissues, her medical history, and her realistic expectations. That is why, before deciding on a technique, the initial consultation is essential: it is where the shape, size, position of the areolas, and skin quality are evaluated to determine which procedure or combination best suits the case.
Below, I explain the 3 most common breast surgeries, when each is indicated, how they are performed, and what to expect from the results.
The breast augmentation is a surgery whose main objective is to increase volume and improve the shape of the breasts. It is the indicated option when a patient feels her breasts are small in proportion to her body, has lost volume after pregnancy, breastfeeding, or significant weight loss, or is looking for more projection and fullness in the cleavage.
There are three ways to perform a breast augmentation, and the choice depends on each patient's goals:
This is the most requested technique because it offers predictable and long-lasting results. High-quality implants approved by the FDA are used, available in different shapes (round or anatomical) and profiles (low, moderate, high, or extra-high). The size and profile are chosen based on the patient's chest measurements and the volume she wishes to achieve.
This technique uses the patient's own fat, extracted via liposuction from other areas of the body, to be injected into the breasts. It is ideal for subtle to moderate augmentation in patients who also wish to contour their shape. The projection achieved is less than with implants, but the result is 100% natural.
Combines implants and the patient's own fat in a single procedure. The fat is placed over the implant to soften the edges and achieve a more natural transition, especially in the upper pole of the breast. It is ideal for patients with limited breast tissue coverage.
Implants can be placed in different planes depending on each patient's anatomy and the desired result: subglandular (under the breast gland), subfascial (under the muscle fascia), submuscular (under the pectoral muscle), or dual plane (a combination of planes). Each option has specific indications based on the amount of breast tissue, skin elasticity, and breast shape.
The most common incision in Bogotá is under the breast, in the inframammary fold, because it remains hidden and allows for precise control during surgery. It can also be performed through the areola, although this approach has more specific indications.
Initial recovery takes between 1 and 2 weeks, although fine-tuning can take several more weeks. The final results of a breast augmentation are seen between 6 months and a year after surgery, once the tissues have fully settled.
Breast reduction is the indicated surgery when breast size causes physical, functional, or aesthetic discomfort. It involves removing excess glandular tissue, fat, and skin to reduce breast volume, lift them, and improve their shape.
It is recommended for patients who experience:
Many patients who come in for a breast reduction report an immediate improvement in their quality of life after the procedure, both physically and emotionally.
Breast reduction combines several elements into a single surgery: excess tissue and skin are removed, the areola is repositioned to a higher, more harmonious location, and the breast is reshaped to give it a more youthful and firm appearance. In many cases, the size of the areola is also reduced if necessary.
Depending on the extent of the reduction, the scars may be:
Although scarring is part of the procedure, with proper care it fades significantly over time and is usually an acceptable trade-off for the relief from discomfort that reduction provides.
Initial recovery takes between 2 and 3 weeks, with a gradual return to normal activities. The final result is visible between 6 and 12 months, once swelling has completely subsided and the scars have matured.
The mastopexy is the surgery indicated to correct breast sagging (breast ptosis) and restore firmness, shape, and projection. It does not change the size of the breasts, but rather their position: it reshapes the breast tissue, removes excess skin, and repositions the areola to achieve a higher, more natural-looking neckline.
It is recommended when the patient experiences:
The degrees of breast ptosis are classified as mild, moderate, and severe, and the technique used and the resulting type of scar depend on that diagnosis.
Mastopexy can be performed in two ways:
Your own breast tissue is repositioned to achieve firmness and lift, without adding extra volume. It is the ideal option for patients who are satisfied with their current size and only wish to correct sagging. You can read more in the post about mastopexy without implants.
This combines a lift with the placement of implants for patients who, in addition to correcting sagging, desire more volume and projection, especially in the upper pole of the breast. It is one of the most requested combinations for patients who have finished their pregnancy and breastfeeding stage.
As with reduction, the scars depend on the degree of ptosis:
Recovery is similar to that of a reduction: between 2 and 3 weeks to resume daily activities, with the final result visible between 3 and 6 months depending on the technique used.
Choosing between augmentation, reduction, or mastopexy is not always obvious, and many patients arrive at the consultation thinking they need one procedure and leave knowing the real solution is another, or a combination.
As a general guide:
In cases where several factors coexist, for example, sagging breasts with little volume, procedures are combined: mastopexy with implants is one of the most frequent surgeries for patients who have finished their pregnancies and are looking to regain a firm and projected neckline. When there is also excess tissue, a reduction can be combined with a lift.
The only way to define it with certainty is an in-person assessment. During the consultation, we evaluate your complete anatomy, analyze your goals, and design a personalized plan.
Choosing to have any breast surgery in Bogotá with a board-certified plastic surgeon, a member of the Colombian Society of Plastic, Aesthetic and Reconstructive Surgery (SCCP), is the best guarantee of a safe procedure with results that respect your anatomy and your goals. If you are looking to transform your décolletage and bust, I look forward to seeing you in my office for an assessment in Bogotá.
Breast augmentation adds volume to the breasts using implants or your own fat. Reduction removes tissue and skin to decrease size. Mastopexy (a breast lift) repositions sagging breasts without necessarily changing their size. Each addresses a different goal and can be combined when the case requires it.
When sagging and a lack of volume coexist, the indicated surgery is a mastopexy with implants (also called an augmentation mastopexy). In a single procedure, the position of the breast is corrected, and volume and projection are added, especially in the upper pole.
Yes, in many cases, breast reduction includes a lifting component because, by removing excess tissue, the areola is also repositioned. When the main goal is to reduce size while maintaining firmness, both techniques are performed in the same surgery.
Initial recovery takes between 2 and 3 weeks to return to daily activities. Chest and arm exercises are gradually resumed after one month. The final result is visible between 6 and 12 months, once the swelling has subsided and the tissues have settled.
All breast surgery leaves scars, but their placement is planned so they remain hidden under a bra or swimsuit. With proper care—sun protection, not smoking, and following medical instructions—scars fade significantly over time.
Breast augmentation is the most requested breast surgery worldwide. In second place is mastopexy, either alone or combined with implants, and in third place is breast reduction.
The cost depends on the type of procedure, the technique used, the type and brand of the implant (if applicable), and the complexity of the case. A breast augmentation with implants has a different cost than a mastopexy with reduction. During the assessment consultation, the surgical plan is defined and a personalized quote is provided.
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