Best thing to do for saggy breasts?


I'm almost 22 years old and I've noticed that my breasts sag badly. Since I first started puberty and started wearing bras, they still became sag-ish. I lost weight over the years, could this be a factor? What's the best solution to fix this problem?


There are two things that women complain of when they say their breasts are sagging.  One is that there is a scoop on the upper pole of the breast from loss of tissue.  This probably happened when you lost weight.  This usually is just putting in an implant to give you the volume that you lost back into your breast or a breast augmentation.  

The other thing that women complain of is that their nipples point to the floor.  This requires a lift to correct.  You need to have a consultation and physical exam to evaluate if it is one or both of these things.  Good luck.  


If the nipple position is below the inframammary line, which is the most common forms of droopy breasts, then your only alternative is breast lift. Depending on your satisfaction with the size, could be breast lift with or without implants.


 The two issues most commonly expressed issues regarding the appealing breast by women are the size of their breasts and the position of the nipple. A nipple position that is low is commonly referred to as a saggy breast. Correction is usually by a procedure called a mastopexy or breast lift. Anticipate a decrease in cup size of 1/2 to 1 cup with a breast lift.

 The size of a womens breast can easly be adjusted by breast augmentation. Yes, a breast augmentation and a mastopexy can be performed at the same time but, please seek out a qualified surgeon, such as, members of the ASAPS. Best,


Gary R Culbertson, MD, FACS


As a simplified rule of thumb, If the nipple is below the crease under the breast a mastopexy or breast lift.  if the nipple is above the crease then typically an implant will suffice.  Sometimes a lift with implants is indicated to make the breasts not only perkier but also fuller.  you should consult with a board certified plastic surgeon/ASAPS member to evaluate you and discuss your goals and options.



If the breasts are truly "sagging", meaning that the areola/nipple complex appears to be below the inframammary fold, the best available solution is a breast lift. A large percentage of patients will require the placement of an implant at the same time in order to obtain the optimal aesthetic appearance of the breast. A consultation with a board certified surgeon is a must to determine what would be the best choice for your specific problem.


Correction of Sagging Breasts – The best method to correct sagging breasts is a “mastopexy” or breast lift for optimal results. One can do this with or without implants, however if you want superior fullness with a mastopexy then one needs to add breast implants.



Breast sagging means different things to different patients. To some, it is loss of volume and firmness, to others it is a progressive lowering of the nipple-areola position, and to others it is both. Weight loss may contribute to sagging, but there are other factors the play a role, including genetics.

The best correction depends on your anatomy, desired outcome and understanding of the pros and cons of each procedure. If there is adequate volume and the nipple is low, a mastopexy or breast lift may improve the shape and position. If there is less volume than you would like, an implant alone, depending on the location of the nipple-areola, or in conjunction with a mastopexy may be the solution.

You should have a consultation with a plastic surgeon who is certified by the American Board of plastic Surgery and a member of the American Society for Aesthetic Plastic Surgery.

Robert Singer, MD FACS

La Jolla, California






Having a breast lift operation involves making a decision to trade an improved breast shape and contour for some (well-placed and concealed) surgical scars on the breast. For the Raleigh breast lift patient who is displeased that her nipples are downpointing, it may be a relatively easy decision. The surgical incisions are strategically placed to be as minimally noticeable as is possible. One component is around the areola, which is usually well concealed by the color difference between breast skin and areolar skin. The second component extends vertically from the '6 o'clock' position of the areola to the fold below the breast, and as the majority of this scar faces downward, it is usually quite acceptable.



The goal of mastopexy surgery is to produce an aesthetically pleasing, projecting breast that ideally maintains its improved shape over time. This can only be accomplished by some internal rearrangement of breast tissue which often involves removal and/or repositioning of lower pole tissue, and suture repair of the internal structure of the breasts. Unfortunately, the terms used to describe different mastopexy surgeries primarily refer to the surgical scars, and they do not communicate what technique is used to actually produce the lifted breast appearance.

Breast lift surgery (mastopexy is a surgery to lift the breasts. An important concept for prospective patients to understand is the fact that a breast lift which is a skin surgery only, when performed on breasts with significant volume and advanced ptosis (droopiness), is doomed to fail. Skin is elastic and stretches out when placed on tension, and is therefore unable to support the weight of the breast over time. A mastopexy that consists only of removal of skin excess without some internal rearrangement of breast tissue will inevitably result in a breast that appears bottomed out and once again droopy over time.  A ‘bottomed out’ appearance refers to a breast where lower pole tissue has stretched out the lower pole skin, allowing the lower pole tissue to descend below the inframammary fold. Bottoming out of lower pole tissue also serves to ultimately make the nipple-areola complex appear too high on the breast, which is a distinctly unaesthetic mastopexy appearance and is to be avoided at all costs. 

I strongly prefer to perform mastopexy surgeries primarily using a vertical mastopexy technique, which includes removal of excess lower pole tissue below the nipple-areola complex. Once the tissue is removed, the remaining medial and lateral lower pole elements are sutured together below the nipple-areola complex to tighten the lower pole and lift the breast. In patients who need additional upper pole fullness, the central lower pole tissue that would otherwise be removed can actually be mobilized but left attached to the chest wall at its base - which preserves its blood supply - and then advanced in a submammary pocket behind the upper pole of the breast where it is sutured to the chest wall to maintain its lifted position. This is referred to as an ‘auto-augmentation mastopexy’, and in appropriate patients it is an excellent technique for creating long-lasting upper pole fullness in a mastopexy patient who does not require (or who does not want) simultaneous breast augmentation using an implant, but who would benefit from additional breast volume locally in the upper poles.


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