The International Society of Aesthetic Plastic Surgery released its 2025 global survey on September 29. Among its findings: breast lifts rose 48.1 percent in a single year, to 1,143,862 worldwide, and are now the fourth most common cosmetic operation on the planet. Breast augmentation slipped 2.2 percent over the same year, and implant removals are up 42 percent since 2021.

Dr. Frank Agullo, who founded Southwest Plastic Surgery, was not surprised. “In my practice, I have seen breast lifts as one of the most common procedures performed.”

Here, in his words, is what patients ask about the lift, and how he answers.

The One Exam That Decides It

The lift-or-implant question is settled in the mirror, not online. From one of Dr. Agullo’s RealSelf answers this spring:

“Where the nipple sits relative to the IMF is the entire question. Above the fold leans aug alone, or aug plus a small doughnut lift for better symmetry and perkiness. BodyTite if skin is borderline. At or below the fold leans an honest mastopexy, and an implant alone in that setup will make the heaviness worse.”

The IMF is the inframammary fold, the crease under the breast. If the nipple sits at it or below it, a lift is the honest answer.

Same Size, Smaller, or Larger

“So when a patient comes in for a lift, usually they do need a full breast lift, unless the nipple areolar complex is above the inframammary fold, in which case we can offer a circumareolar, or donut, lift. Once we’ve identified that a lift is necessary, we ask the patient whether they want to stay the same size or slightly smaller, or if they want to be larger. Of course, if they want to be larger, we will need an implant or a fat transfer to the breast.”

For the patient who wants a lift and nothing else: “they may be the same size or slightly smaller, maybe half a cup size to a cup size, because we are removing that excess skin. The breast will be perkier, but it’ll also be tighter, and it may appear smaller.”

The practice’s guide to the breast lift with implants covers the combined operation.

The Donut Lift Changed the Conversation

“I think a lot of patients are afraid of this surgery because they feel like they’re going to need the full anchor type incision. By offering the circumareolar, or donut, lift for patients whose nipple and areola are above the inframammary fold, this can be a game changer.”

Dr. Agullo also resets expectations early. “A lot of patients having a breast lift with implants are expecting a lot of upper fullness and a very high implant placement, which is just not possible at the same time as a breast lift. A breast lift will always give a perkier look, more upper fullness, and cleavage, but it’s going to have usually a natural slope on top.”

The Internal Bra

Nearly every lift at the practice now includes internal mesh support, which Dr. Agullo described in a dictation this week:

“I actually recommend internal mesh support on all patients, on breast lifts, breast reductions, and breast augmentations.”

“In a breast lift and a breast reduction, it actually helps reshape the breast tissue and support it, just like a push-up bra, to gain more upper pole fullness and avoid bottoming out and lateral displacement.”

“The mesh supports the tissues for a period of up to two years. As it dissolves, it leaves behind collagen deposits, so the support remains there even well after the mesh has gone.”

Details are on the internal bra page, and Dr. Agullo’s full read of the ISAPS numbers is on agulloplasticsurgery.com.

Cost

As of this writing, a breast lift at the practice runs from $10,000 to $14,000 depending on whether the internal bra mesh is used, and a lift with implants from $13,500 to $17,500. Current figures are on the fees page. An exact quote can only be provided after a consultation.

Why Choose Dr. Agullo

Double board-certified by the American Board of Plastic Surgery and the American Board of Surgery. Mayo Clinic plastic surgery fellowship. Clinical Associate Professor of Plastic Surgery at Texas Tech University Health Sciences Center. Castle Connolly Top Doctor for 13 consecutive years. He performs lifts with and without implants, with fat transfer, and with the internal bra.

Ready to Talk?

If you have been wondering whether you need a lift or an implant, book a consultation at Southwest Plastic Surgery and find out where your fold is.

Call the office at (915) 590-7900, text us at 1-866-814-0038, or book a consultation at agulloplasticsurgery.com/appointments. #StayBeautiful

@RealDrWorldWide on Instagram, TikTok, and Snapchat, @Agullo on X, or @AgulloPlasticSurgery on Facebook.

Statistics: International Society of Aesthetic Plastic Surgery, ISAPS International Survey on Aesthetic/Cosmetic Procedures Performed in 2025.