Sagging or volume?The surgery you need depends on which

Breast Guide

Breast Surgery: Which Procedure Is Right for You?

Breast surgery is divided into breast lift, breast augmentation, breast reduction and breast revision depending on whether the problem is sagging or volume, and it also includes nipple and areola surgery, tuberous breast correction and breast reconstruction.

The question we hear most often in breast consultations is whether to have an augmentation or a lift. To answer it, we look first not at size but at the position of the nipple. If the nipple sits at or below the inframammary fold, the problem is sagging, and adding volume will not resolve it. If the nipple position is within the normal range but the upper part of the breast looks empty, the problem is volume. If the discomfort is that the breasts are large and heavy, the answer is reduction; and if the problem arose after a previous surgery, investigating the cause comes first.

Breast consultations at Atelier Plastic Surgery start from this judgment. We check the degree of sagging, the amount and elasticity of the skin, the amount of breast tissue, the size of the areola, differences between the two sides and the proportion to your body, and on that basis we decide which of lift, augmentation, reduction or revision is needed, or whether two should be combined in a single surgery. Dr. Juyoung Go has lectured at conferences in Korea and abroad over many years on how to choose the incision pattern for each patient, and serves on the academic committee of the Korean Society of Breast Plastic Surgery.

We apply the same principles to the shape of the nipple and areola, to structural conditions such as tuberous breast, to reconstruction after breast cancer surgery, to chest surgery aligned with gender identity, and to accessory breast tissue in the armpit. Find the item below that is closest to your concern and go to its page to see the methods, recovery, precautions and related research for each surgery. All consultations, surgery and follow-up are handled by the Director herself, and only one general-anesthesia surgery is performed per day.

Based on what the concern is

My breasts sagThe nipple sits level with or below the inframammary fold, and the breast tissue has settled downward so the upper part looks empty. The main causes are pregnancy and breastfeeding, weight changes and the loss of skin elasticity that comes with age. Adding volume alone does not raise the nipple, so if sagging is the main problem, a lift comes first. The incision pattern, periareolar, vertical or inverted-T, is chosen by the degree of sagging.

Breast liftWhen sagging is the main problem and you want to keep your current size Implant breast augmentationWhen sagging comes with a lack of upper volume and a lift and augmentation are planned together (augmentation mastopexy)Breast reductionWhen the sagging breasts are large and heavy and you also want to reduce their size

My breasts lack volumeThe nipple position is within the normal range, but the breasts are small overall or the upper part is hollow. We choose between implant and non-implant methods based on how much enlargement you want, how much body fat is available for harvesting and how you feel about implants. For slim builds with thin subcutaneous tissue, we consider a hybrid method that combines an implant with fat grafting.

Implant breast augmentationWhen you want an increase of a cup size or more, or there is not enough fat to harvest Non-implant breast augmentationWhen you want an increase of about half a cup to one cup and have fat available, or do not want an implant Breast liftWhen mild sagging is also present and augmentation alone would leave the nipple looking low

My breasts are large and heavyThe weight of the breasts causes discomfort such as shoulder, neck and back pain, bra-strap marks and eczema in the fold beneath the breast. Sagging is usually present as well, so reduction and lift are done in one surgery. Fullness at the front of the armpit may be accessory breast tissue rather than breast, in which case it is addressed separately by liposuction or excision.

Breast reductionWhen reducing breast tissue and skin to correct size, weight and sagging together Accessory breastWhen fullness at the front of the armpit bothers you

I have had problems since a previous surgeryThis includes hardening around the implant (capsular contracture), an implant that has shifted downward or to the side, the two sides becoming different, or implant folds showing through thin skin (rippling). Late skin sagging, in which the skin loosens again some time after augmentation mastopexy, also belongs here. The causes often overlap, so the first step is an ultrasound examination to identify them.

Breast revisionWhen identifying and correcting the cause of a problem that arose after a previous surgery Non-implant breast augmentationWhen fat grafting is used to soften a visible implant edge or rippling

I am concerned about the shape of my nipples or areolasThe size and position of the breasts are fine, but the nipple is long or thick, the areola is wide, the nipple is drawn inward, or the two sides differ. Tuberous breast, in which the areola protrudes and the fold beneath the breast sits high, is a problem of the lower breast structure rather than the nipple and areola alone, so it is treated separately. Most nipple and areola surgery is performed under local anesthesia or sedation, and it is sometimes combined with other breast surgery.

Nipple reductionWhen reducing the length or thickness of the nipple Areola reductionWhen reducing the diameter of an enlarged areola Inverted nippleWhen the nipple is drawn inward Nipple deformityFor shape problems other than inversion, such as asymmetry, double nipple or an enlarged nipple Tuberous breastFor tuberous breast, in which the areola protrudes and the fold beneath the breast sits high

At a glance

Surgery · Treatment	Main concern	Incision · Approach	Anesthesia	Recovery
Breast lift	Sagging (low nipple position)	Periareolar · vertical · inverted-T	General	About 1–2 weeks
Implant breast augmentation	Lack of volume	Inframammary fold · areola · armpit	General	About 1 week
Non-implant breast augmentation	Modest volume supplement	Small injection incisions	Sedation or general	About 3–5 days
Breast reduction	Size · weight · sagging	Vertical · inverted-T	General	About 1–2 weeks
Breast revision	Capsular contracture · malposition · asymmetry · rippling	Existing incision line	General	About 1–2 weeks
Nipple reduction	Nipple length · thickness	Within the nipple	Local or sedation	About 3–5 days
Areola reduction	Wide areola	Areola border	Local or sedation	About 5–7 days
Inverted nipple	Nipple inversion	Small incision at the nipple base	Local or sedation	About 3–5 days
Nipple deformity	Asymmetry · double nipple · enlarged nipple	Within the nipple	Local or sedation	About 3–5 days
Tuberous breast	Constricted lower breast · protruding areola	Periareolar (with augmentation if needed)	General	About 1–2 weeks
Breast reconstruction	After breast cancer surgery	Existing mastectomy incision · donor site	General	About 2–4 weeks
Gender-affirming chest surgery	FTM chest contour · MTF volume	FTM periareolar or double incision · MTF inframammary fold, etc.	General	About 2 weeks
Accessory breast	Residual breast tissue in the armpit	Small incision in the armpit	Sedation or general	About 3–7 days

Recovery periods are typical ranges and vary by individual.

Procedures

Breast Surgery

Implant breast augmentation

The implant size and pocket plane are chosen by your build and tissue thickness. Covers the subfascial approach and the hybrid method (implant plus fat grafting).

Non-implant breast augmentation

Volume is added with autologous fat, hADM or HA. The method depends on how much enlargement you want and how much body fat is available.

Breast lift

Loose skin is removed and the nipple is raised. The key is choosing the incision pattern by the degree of sagging.

Breast reduction

Excess breast tissue and skin are removed to reduce weight, and in most cases a lift is done at the same time.

Breast revision

Capsular contracture, implant malposition, asymmetry, rippling and late skin sagging, addressed from the diagnosis of the cause onward.

Nipple · Areola

Nipple reduction

Reduces the length or thickness of the nipple to bring it into proportion with the breast as a whole.

Areola reduction

Reduces the diameter of an enlarged areola to bring it into proportion with the breast.

Inverted nipple

Corrects a nipple that is drawn into the breast, according to the degree of inversion and with the milk ducts in mind.

Nipple deformity

Corrects shape problems other than inversion, such as asymmetry, double nipple and an enlarged nipple.

Breast Conditions · Reconstruction

Tuberous breast

Corrects, from the structure up, a breast whose lower part is underdeveloped, with a protruding areola and a high fold.

Breast reconstruction

Rebuilds the shape of the breast after breast cancer surgery. Divided into immediate and delayed reconstruction.

Gender-affirming chest surgery

For FTM, the goal is removal of breast tissue and chest contouring; for MTF, creating volume with implants or fat grafting.

Accessory breast

Residual breast tissue in the armpit is addressed by liposuction or excision, depending on the proportion of fat to glandular tissue.

After surgery

After surgery and recovery care

Most breast surgery is performed under general anesthesia, and Atelier Plastic Surgery performs only one general-anesthesia surgery per day. An anesthesiologist works alongside the surgeon, and after surgery you recover in a private recovery room before going home the same day or the next. Stitches are generally removed at about 1–2 weeks, return to light daily activities takes about 3 days to 2 weeks depending on the surgery, and exercise resumes after about 4–6 weeks; all of this varies by individual. Nipple and areola surgery is performed under local anesthesia or sedation, so recovery is shorter. After implant surgery, the condition of the implants is checked with regular ultrasound examinations. The standards for everything from anesthesia management and emergency response to infection prevention and recovery care are described on the Safety Care System page.

Safety Care System · Aftercare schedule

Related treatments in other categories

Safety Care System

Leads on to the post-operative course and recovery schedule, and our standards for anesthesia, infection and recovery care

Personal Consulting

A consultation program that reviews your body shape, daily routine and recovery environment together before deciding on surgery

Academic Activity

The full list of related research for each page and the director's society positions

Related research

Dr. Juyoung Go's academic activity in this field

ConferenceSpeaker

Mastopexy Decision Making: Choosing the Right Incision Pattern for Your Patient

Aesthetic Plastic Surgery Korea (APS Korea) 2026 · Breast 3 Session · 2026.04.12 · Seoul Dragon City

A lecture on the criteria for choosing the incision pattern according to the degree of sagging and the condition of the tissue
ConferenceSpeaker

How to Choose Skin Resection Patterns in Various Mastopexy

Korean Society of Plastic and Reconstructive Surgeons, 80th Congress (PRS Korea) · 2022.11 · Seoul

How to choose the skin resection pattern in different types of breast lift
ConferenceSpeaker

Augmentation Mastopexy; Late Envelope Failures

Seoul Breast Meeting 2026 · Video Session: Complication Prevention & Management in Aesthetic Breast Surgery · 2026.07.12 · Maria Hall, Catholic University of Korea College of Medicine, Seoul

Prevention and management of skin sagging that develops some time after augmentation mastopexy
PaperFirst author

Scar-Free Nipple and Areola Contouring: A Crown-Shape Debulking Method for Enhanced Aesthetic Outcomes

Plastic and Reconstructive Surgery · 2026DOI ↗

A study presenting a crown-shaped debulking method that removes tissue from inside the nipple and areola without incising the outer skin
PaperFirst author

A Novel Method Using the Petal Pattern for Contouring a Domed Nipple in Tuberous Breasts

Plastic and Reconstructive Surgery · 2024DOI ↗

A study presenting a petal-pattern method for reshaping a dome-shaped nipple in tuberous breasts

Each treatment page lists the items relevant to it; the full list is on the Academic Activities page. View all academic activities

FAQ

Q1How can I tell whether I need an augmentation or a lift?

Stand in front of a mirror and check whether your nipple sits below the fold beneath your breast. If it does, sagging is the main problem and a lift is needed. If the nipple sits above the fold but the upper part of the breast looks empty, the problem is volume. The two often occur together, and at consultation we measure the degree of sagging and the amount of tissue before telling you precisely.

Q2Can a lift and an augmentation be done at the same time?

When sagging and a lack of volume are present together, they are often done in a single surgery. However, a lift reduces skin while an augmentation stretches it, so when sagging is severe or the skin is thin, we sometimes divide them into two stages. We decide at consultation based on the examination findings.

Q3Which is better, an implant or fat grafting?

It depends on how much enlargement you want, how you feel about implants and how much fat is available for harvesting. If you want a natural change of about half a cup to one cup and have fat available, fat grafting is often suitable; if you want an increase of a cup size or more, an implant is often the better fit. If the subcutaneous tissue is thin, there is also a hybrid method that combines the two.

Q4What tests are done before surgery?

At consultation, breast ultrasound is used to check the thickness of the breast and subcutaneous tissue and the condition of any existing implants, and a 3D simulation shows the expected shape. Before surgery, basic tests for general anesthesia such as blood tests, an ECG and a chest X-ray are performed, and a mammogram or MRI is requested when needed.

Q5If I plan to breastfeed, when is the best time for surgery?

Pregnancy and breastfeeding change the size of the breasts and the skin again, so we generally recommend surgery after childbirth and breastfeeding are complete and your weight has stabilized. If surgery is done before then, we choose a method with less effect on breastfeeding, so please tell us your plans at consultation.

Q6Where will the scars be?

It differs by surgery. For implant breast augmentation, the scar is in one of the inframammary fold, the areola or the armpit; for breast lift and reduction, it follows one of the periareolar, vertical or inverted-T patterns depending on the degree of sagging; and for nipple and areola surgery, the scar sits within the nipple or areola. The incision site is described in the methods section of each page, and scar care is provided after stitch removal.

Q7How long does recovery take?

It depends on the type of surgery. Return to light daily activities is typically after about 3–5 days for nipple and areola surgery, about 1 week for implant augmentation and about 1–2 weeks for lift, reduction and revision, and exercise is resumed gradually after about 4–6 weeks. This varies by individual, and the table above and the recovery section of each page give step-by-step guidance.

Q8Who conducts the consultation and performs the surgery?

Dr. Juyoung Go handles everything herself, from consultation through surgery and post-operative follow-up. Only one general-anesthesia surgery is performed per day, an anesthesiologist works alongside her, and the clinic operates operating-room CCTV and private recovery rooms.