Rejuvenating Sagging Breasts

Plastic Surgeons Heather Furnas, MD, and Francisco Canales, MD Plastic Surgeons Heather Furnas, MD, and Francisco Canales, MD explain treatment of Sagging Breasts

If you come across the recent Bathing Suit issue of Sports Illustrated, look closely. Some of the models have sagging breasts. Let’s face it. Breasts sag. Eventually almost all but the smallest breasts sag as the skin, breast tissue, fat, and supporting ligaments lose their tone.

Reasons for Breast Sagging

Women with sagging breasts usually fall into one or more of the following categories. 1. They wear or wore a B-cup bra or larger. 2. They’ve been pregnant and may have breastfed. 3. They've gained and lost weight. 4. They have tuberous breasts. 5. They developed that way. (Even teens can have drooping breasts!)

Why Women Want Sagging Breasts "Fixed"

It may come as no surprise that women with sagging breasts often want to be “perky," but it's not always for the reasons you might think. Here's what those women say: 1. The appearance of their breasts clothed and unclothed impacts their self-confidence. 2. The upper breast can be flat or even concave. 3. Gaping of bras and bathing suit tops can lead to embarrassment while bending over. 4. They're self-conscious in a low-neck top, when the upper breast skin jiggles and sags. 5. Their breasts are so loose, they fall out of a bra or a bathing suit top. 6. The hanging skin is hot in the summer. 7. Rashes may develop under their breasts.

Consultation with a Plastic Surgeon

If you’re someone with sagging breasts who wants to rejuvenate them, start by finding a board-certified plastic surgeon with good before-and-after photographs. After listening to your goals, he or she can examine you, take your breast measurements, feel your tissue, and make a recommendation. What will your plastic surgeon be looking for? In addition to tone, symmetry, and shape, the focus will be on the degree of sagging, which can be determined by where the nipple lies in relation to the breast crease. Below are three degrees of droopiness.

The “Deflated” Breast

When the nipple position is at or above the crease that lies beneath the breast, the deflated breast isn’t truly sagging. It’s more like a balloon that's first inflated and then deflated. (Hence the common term.) Like breasts with true sagging, the upper part of the emptied breast can be flat or concave. For the deflated breast, a breast augmentation can round out the shape, while giving a fuller, more youthful contour. No lift is needed.

The Slightly Sagging Breast

In the slightly sagging breast, the nipples lie below the breast crease by no more than about an inch. A breast augmentation alone might leave the nipples still dangling or pointing down, so a donut mastopexy is sometimes done. The donut mastopexy slides the nipples upwards, closer to the “equator” of the breast implant, so they face proudly ahead, instead of looking toward the ground.

The Very Sagging Breast

When the nipples lie more than an inch below the breast crease, the rest of the breast usually hangs low as well, indicating that there's too much skin. The only way to treat that is to remove the extra skin. That means a breast lift. By getting rid of that skin, a breast lift (mastopexy) not only lifts the nipples, it also creates smaller, tighter skin envelopes. A breast augmentation can then add the youthful fullness that completes the breast rejuvenation. Some women are resistant to a breast lift because the procedure leaves scars. But the woman with very saggy breasts who doesn't have a breast lift and counts on a breast augmentation alone to lift up her breasts will likely have one of two outcomes: Either (1) the empty, drooping breast will sag below the breast implants and swing like a hammock or (2) the breast implant will drop, giving a saggy, matronly look. Neither is likely to achieve the patient's goals. In women with heavier breasts, a breast reduction can reduce the size while also lifting the breasts.

Can Your Plastic Surgeon Give you Perky Breasts?

Women with truly sagging breasts will never have a perky result, defined as full, round breasts perched entirely above the crease. Once the breasts have lost their tone, they’ll never regain it, and no plastic surgeon can change that.

The Secret to Happiness with Plastic Surgical Results

If you’re considering surgery for sagging breasts, look at before-and-after photos and focus on women with breasts like yours. If your goal is to look like patients who look nothing like you before their surgery, you’ll never be satisfied. However, if you have reasonable expectations and you choose an excellent board-certified plastic surgeon, you’re very likely to be happy.

* All information subject to change. Images may contain models. Individual results are not guaranteed and may vary.