Dr. Karen Horton has either authored or reviewed and approved this content.
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Aging, pregnancy, breastfeeding, weight loss, and genetics can all contribute to changes in breast shape and volume. If you are in the San Francisco Bay Area and looking to restore a youthful, lifted, and fuller breast appearance with better upper pole volume, a breast augmentation with lift, also known as a mastopexy-augmentation, may be the ideal solution. This cosmetic surgery combines two powerful surgical procedures, a breast lift and breast augmentation, to elevate sagging breasts and enhance breast volume, improving self-confidence and body balance.
At our San Francisco practice, our Board-Certified Plastic Surgeon, Dr. Karen Horton, uses advanced surgical techniques to customize each procedure to your anatomy and specific aesthetic goals. She emphasizes natural-looking results and proportional breast rejuvenation. Surgery is performed on-site in our fully accredited Quad A-certified in-office surgery center, ensuring the highest standards of safety and care in California.
"Combining a lift with augmentation is like restoring both the foundation and the facade of a home, it provides the structural support needed for a beautiful, lasting result."
- Dr. Karen Horton
This Plastic Surgery procedure combines a breast lift procedure (mastopexy), which lifts and reshapes sagging breast tissue and repositions the nipple and areola, with breast augmentation surgery to increase fullness using saline implants or silicone gel implants. This combined cosmetic procedure addresses breast asymmetry, breast sagging, and loss of volume due to breastfeeding, weight loss, or aging. In most cases, liposuction of the axillary rolls is added to remove unwanted fat in the armpits and bra rolls.1
The result is a more cohesive, lifted, and enhanced breast shape that complements your figure and restores natural beauty, often obviating the need to wear a bra. Patient satisfaction rates for combined mastopexy-augmentation procedures are high when performed by a Board-Certified Plastic Surgeon, with many patients reporting significant improvements in body image and self-esteem.
"My goal is always to create a silhouette that feels as natural as it looks, ensuring every patient leaves with a renewed sense of self-confidence."
- Dr. Horton
Visualizing your potential results is an essential part of your surgical journey. We invite you to explore our extensive gallery of real patients who have undergone a breast lift with augmentation at our San Francisco practice since 2006. These photos showcase the natural-looking results, improved breast symmetry, and restored volume that our Board-Certified Plastic Surgeon, Dr. Karen Horton, achieves for her patients.
Drag the slider to see transformation
Drag the slider to see transformation
A good candidate is typically a healthy, non-smoking woman at or near her target weight. Candidates often seek this breast enhancement due to:
Please see our Preparing for Surgery section to learn more about ensuring you are an ideal candidate for surgery and establishing realistic expectations.
Patients taking GLP-1 medications, such as semaglutide, for diabetes or weight management should discontinue use at least 30 days prior to any procedure involving general anesthesia. This precaution helps reduce the risk of complications during surgery. Read ourblog to explore safety guidelines for people using weight loss or diabetes medications.
Your surgical procedure will take place under general anesthesia in our state-of-the-art, accredited surgical suite. The breast augmentation procedure typically lasts 3 to 4 hours and is performed on an outpatient basis. Incisions vary based on the degree of lift needed, most commonly a lollipop or vertical incision, or a periareolar incision, with another incision hidden in the breast fold.
During the breast augmentation surgery, breast implants are placed on top of the chest wall muscle in the subglandular position, and excess skin is removed to create a lifted, fuller profile. Liposuction is added to further contour the bra rolls and armpit region, known as the axillary rolls. Dr. Horton will discuss the types of implants available, including silicone implants, saline implants, and “gummy bear” or teardrop shapes, to ensure a natural feel and look.
The FDA has approved both saline and silicone implants for breast enhancement, noting that they are among the most studied medical devices in history.
Please see our Preparing for Surgery section for more details about what happens in the operating room on the day of surgery, specifically during breast lift surgery and during the breast augmentation procedure.
You will receive a personalized treatment plan with specific post-operative instructions online and in printed form at your initial consultation and preoperative visit. Most patients return to light activity within two to three weeks and to their normal routines in 4 to 6 weeks. Post-surgery, you will experience temporary swelling, bruising, and altered nipple sensation, all of which improve with healing and time.
Most patients can return to work within one to two weeks, depending on the physical demands of their job. You will be monitored closely during the healing process to ensure the best possible outcome and to minimize risks such as capsular contracture.
The final results, enhanced volume, symmetry, and a youthful contour, become more apparent as swelling subsides. We may also provide guidance on skin care to optimize your results.
Where can I find a breast lift with augmentation near me
If you are in San Francisco or the surrounding Bay Area, Dr. Karen Horton offers personalized breast lift with augmentation procedures. As a Board-Certified Plastic Surgeon, she combines artistic vision with surgical precision to deliver natural-looking results that align with your aesthetic goals.
Can I combine any other treatments with a breast lift and augmentation?
Yes, many patients choose to combine their breast enhancement with other body contouring procedures. This is common in a mommy makeover, where a tummy tuck, liposuction, or even a facelift can be performed to achieve comprehensive rejuvenation. Some patients also explore non-surgical options like dermal fillers or specialized skin care to complement their surgical results.
What are the different types of mastopexy and augmentation?
There are a variety of options for each technique of mastopexy (breast lift) and breast augmentation. Please visit our breast lift page to learn about mastopexy options, incisions, and expected recovery. Visit our breast augmentation section to learn all about breast implants, the science and safety behind them, saline versus silicone gel, implant size, and additional education specific to breast augmentation.
Can I increase breast volume without breast implants?
Dr. Horton exercises caution when considering adding fat in the form of autologous fat transfer to the breasts. This technique uses your body's own fat, harvested from areas such as the abdomen, thighs, or flanks, to naturally add volume to the breasts. Fat transfer, also called free fat grafting and lipofilling, is commonly performed at a second stage in breast reconstruction procedures after mastectomy. However, when fat is added to a natural breast, permanent changes can occur that could interfere with mammograms and breast cancer screening. Learn more in her blog post on this topic.
Is liposuction part of a mastopexy-augmentation?
Liposuction is usually added to breast procedures to help shape the outer regions of the breast, providing the very best contour, and to remove fat from the armpit area and back bra roll regions. Liposuction contouring of the axillary rolls is often performed as part of a combined mastopexy-augmentation procedure. Please see our liposuction section for more information.
What are the risks of combined breast lift with implants?
Before undergoing any surgical procedure, it is important to be aware of the possible risks and complications involved, such as capsular contracture or changes in nipple sensation. We encourage you to review ourPreparing for Surgery section for general information about surgical risks, as well as ourPostoperative Instructions for Breast Surgery for specific details.
If you are considering enhancing the shape and volume of your breasts, Dr. Karen Horton offers breast lift with implants in San Francisco. As a Board-Certified Plastic Surgeon, Dr. Horton specializes in combining breast lift surgery with breast augmentation to help patients achieve youthful, fuller, and more balanced breast contours.
Contact us today to schedule your initial consultation and explore how a personalized breast enhancement can help you feel more confident, youthful, and aligned with your aesthetic goals.
Dr. Karen Horton is an internationally Board-Certified Plastic Surgeon, certified by both the American Board of Plastic Surgery and the Royal College of Surgeons of Canada. She is a Fellow of the American College of Surgeons (FACS) and an active member of the American Society of Plastic Surgeons and The Aesthetic Society. With over 20 years of experience, she is a recognized leader in aesthetic and reconstructive breast surgery in California. She received her Medical degree from the University of Toronto Faculty of Medicine, a five-year Integrated Plastic Surgery Residency at the University of Manitoba and completed a fellowship in Reconstructive Microsurgery at the The Buncke Clinic, California Pacific Medical Center in San Francisco.
"Dr. Horton delivers a truly elevated, concierge-level experience. From the very beginning, everything was handled with intention, professionalism, and a high level of personal attention. She is clear, thoughtful, and extremely knowledgeable, which made the entire process feel both organized and reassuring.
Her staff is outstanding. The office runs seamlessly, and the level of service is exactly what you would expect from a full-service concierge practice. Communication was prompt, scheduling was effortless, and every interaction felt attentive and respectful.”
- F.C. ⭐⭐⭐⭐⭐
“Dr. Horton and her team are truly amazing. From the moment you walk through the doors you are treated with kindness and respect. But even more importantly, my surgical experience was amazing! Every step of the way, Dr. Horton and her team left me feeling confident and beautiful, inside and out! What an awesome experience!”
- L.M. ⭐⭐⭐⭐⭐
“The most caring and loving surgeon of all time. This was the most sincere and genuine experience I have ever had and I cannot testify enough how amazing Dr. Horton is as a surgeon but also as a person! She makes you feel like family. The staff is also incredible- Mary, Niloo, Nurse Rebecca. Feels like a very empowering female dominated space. Beautiful office and so, so accommodating. You can reach the whole staff so easily at any time, and they make you feel like a part of their team. Always showered with compliments when you walk in. Could not be a more positive environment and I could not be happier with my recovery and results so far. The best not just in San Francisco but arguably anywhere!”
- L.S. ⭐⭐⭐⭐⭐
1 American Society of Plastic Surgeons. What are the benefits of combining breast augmentation and a breast lift? https://www.plasticsurgery.org/news/blog/what-are-the-benefits-of-combining-breast-augmentation-and-a-breast-lift. Accessed January 6, 2026.
Dr. Karen Horton has either authored or reviewed and approved this content.
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Dr. Karen M. Horton
2100 Webster St., Suite 520
San Francisco, CA 94115
Phone: 415.923.3067
We are located in the
Pacific Heights District
in the Pacific Professional Building.
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*Please note: Our office is no longer a Participating Provider for insurance. We can provide a financial quote for what anticipated surgical fees will be after your consultation.
