Dr. Farhad Rafizadeh enjoys an extensive experience in breast surgery in Morristown New Jersey. He can offer the safest and most efficient procedures to patients who make the trip to Morristown to see him. Why do most plastic surgeons suggest a two-stage procedure when it comes to breast lift and augmentation or implant exchange? When a large implant is used over the muscle, most of the blood supply going from the muscle to the overlying skin is interrupted. The blood supply going to the nipple is now mostly coming from the surrounding skin. To do a breast lift, one needs to cut around the areola. If this cut is deep below the dermis and the skin has to be mobilized substantially, the blood supply to the areola and nipple will be compromised. The tension on the skin resulting from the lift will also contribute to less blood getting to the nipple. Many factors can influence the decision about doing this procedure in one or two stages. The most conservative approach is to do the breast lift first and follow with the augmentation or the implant exchange in a month or two. These are situations in which one may consider doing the procedure in one stage. 1) If the lift is minimal and the areola doesn’t have to be moved a long distance, the dermal connection from the surrounding skin to the nipple could be mostly preserved. 2) If no capsulectomy is necessary the capsule would allow some additional blood supply to the breast tissue and the nipple. 3) If the patient accepts a smaller implant to reduce tension in the skin closure. 4) If the patient is young and healthy with no history of smoking, or diabetes. I hope this is helpful. Please let me know if you liked this answer and if there are any other questions.