If your breasts aren't as perky as you remember, you may now call them "saggy." But honestly, the drooping of breasts over time is completely natural and normal. It's one of the things that happens with aging, and certain life events, like pregnancy and breastfeeding, can speed up the trend.
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Still, just because it's normal doesn't mean you're A-OK with it. If breast sagging bothers you, there may be ways to address it, including nonsurgical and surgical procedures, though there are a few key things to keep in mind for each approach.
What Causes Saggy Breasts?
Breasts are made up of fat as well as fibrous and glandular tissue, according to Memorial Sloan Kettering. Glandular tissue includes lobes and ducts, which produce and carry milk to the nipple. Fibrous tissue is the connective tissue that supports breasts and fatty tissue makes up the rest. (Bigger breasts equals more fatty tissue.)
Understanding the anatomy can help you understand what causes breast sag, which is also referred to as ptosis:
1. Aging and Gravity
"Ultimately, over time, the skin and soft tissues of the body — whether it be the face, breasts or abdominal skin — succumb to gravity, leading to descent," Samuel Lin, MD, board-certified plastic surgeon and associate professor of surgery at Harvard Medical School, tells LIVESTRONG.com.
Your genes play a role in the soft tissue and structure of breasts, Dr. Lin says. "There can be a predisposition for descent or sagging," he adds.
Unfortunately, your genetic disposition to drooping isn't something you can change.
3. Significant Weight Loss
When you lose fat, the shape of your breasts can change.
"When breast weight pulls on the skin, some of that tissue and skin doesn't recoil to its original position after weight loss," Dr. Lin says.
4. Pregnancy and Breastfeeding
Breasts often change in size during pregnancy. In fact, per a May 2010 review in Annals of Plastic Surgery, 85 percent of women who had at least one pregnancy reported that their breast size changed after pregnancy, with some women noting that their breasts got bigger and others saying they got smaller.
If you are breastfeeding, your breasts swell with milk. When pregnancy and breastfeeding are over, your breasts will likely return to their smaller size. But the stretching they've undergone may leave them with a not-as-full, "deflated" look. That said, some research — including a September-October 2008 study in Aesthetic Surgery Journal — pinpoints pregnancy as the cause of sagging, not breastfeeding.
The free radicals created by cigarette smoke degrade the elasticity of connective tissues in the body. That's why smoking has been flagged as a risk factor for breast sagging, per the May 2010 review in Annals of Plastic Surgery.
Can You Lift Breasts Without Surgery?
Part of the pertness of breasts lies with the pectoral muscle. This muscle is located under the breasts and plays a part in supporting them.
"Therefore, training and developing the chest muscle can lift the breast tissue, giving them a perkier appearance," Brittany Noel Robles, MD, MPH, ob-gyn and certified personal trainer at PostpartumTrainer.com, tells LIVESTRONG.com.
So, strengthening the chest muscles will help lift your breasts, Dr. Robles says. That said, there are limitations to exercises for this condition: "Results won't be anywhere near as dramatic as the results you can get from surgery," she says.
Still, it's healthy for everyone to strengthen these muscles, saggy breasts or not.
There are a few exercises you can start out with, Dr. Robles suggests. She recommends starting with 15 minutes per day, two to three times per week. But if you feel more comfortable beginning with five minutes a few days per week, that's great, too.
1. Wide-to-Close Grip Push-Up
A twist on a classic push-up, this version trains the chest from different angles, Dr. Robles says. "A wider grip will de-emphasize the triceps while activating the chest and the shoulders more than a traditional pushup. Changing your grip also adds variety," she says.
Before you try the wide-to-close grip push-up, make sure you review exactly how to do the perfect push-up. If you're still working toward a push-up, Dr. Robles says you can start by doing push-ups against a wall and then with hands on an incline. Both of those positions will still allow you to try a wide and close grip.
- In a push-up position, make sure your hands are wider than your shoulders.
- Lower down to do a push-up and press back up to starting position.
- Bring hands closer than shoulder-width.
- Lower down to perform another push-up. Press back up to the start, then repeat.
2. Up-and-Down Plank
"This plank adds mobility and upper-body strength compared to the traditional plank. That activates the chest muscle, as this resembles a push-up and adds challenge and variety," Dr. Robles says. This can also be called a "plank push-up."
- Start in push-up position.
- Lower one arm until your forearm and elbow rest on the ground.
- Lower the other arm until your forearm and elbow rest on the ground.
- Push back up into a push-up position, one arm at a time.
- Repeat, alternating which arm goes first.
3. Lying Dumbbell Fly
Make this exercise a regular part of your chest-strengthening routine. "This movement takes the chest muscle through its full range of motion, activating parts that aren't typically worked out doing standard push-ups," Dr. Robles says.
- Lay on an exercise bench or on the floor with your knees bent and feet flat on the floor.
- Hold one dumbbell in each hand and extend elbows to lift the weight above your chest. Your arms should be shoulder-width apart. Your palms should face each other.
- Lower each dumbbell out to your side in an arc, allowing elbows to bend.
- Stop when you reach the floor.
- Press dumbbells back together to the start position. Repeat.
How to Treat Saggy Breasts
The treatment for saggy breasts is through a surgical breast lift, Dr. Lin says. This surgery has increased by 70 percent over the last 20 years, according to the American Society of Plastic Surgeons (ASPS).
Called a mastopexy, this surgery removes excess skin and tightens breast tissue to correct sagging, the ASPS explains. It can also reduce areola size, which can also become larger over time.
What to Know About Breast-Lift Surgery
There are important considerations to make to determine if you are ready for breast lift surgery:
1. It Causes Scarring
"In order to lift the breasts through surgery, there will be scarring," Dr. Lin says.
If this is something you are not comfortable with, you should hold off on surgery, he says. At the very minimum, the incision (and subsequent scarring) will go around the areola. Incisions may also be made vertically down the breasts and horizontally around breast creases.
2. It Won't Even Out Your Breasts
Breasts are often asymmetrical — meaning one breast is larger or a different shape than the other — and this is completely normal. Gravity often pulls down one side more than the other, making these differences more noticeable, Dr. Lin says.
Surgery to lift the breasts won't fix this asymmetry, which is important to be aware of when you're making your decision, he says.
3. It Doesn't Change the Size of Your Breasts
A breast lift won't change the size of your breasts. A breast-reduction surgery can make their size smaller, while implants can make them bigger. Some patients opt to have both a lift and implants or a lift and reduction.
4. It's Expensive
Surgery to lift breasts costs $4,693, on average, according to ASPS data. In addition to this price, you will also have to pay fees for anesthesia, the operating room, testing and medication. And keep in mind that adding reduction surgery or implants increases the overall cost quite a bit.
5. There's a Recovery Period
As for outcomes, you will notice a new, more supported shape and the areola will be placed in a perkier position, too. It may take four to six weeks of recovery, which means no heavy lifting and wearing support garments, Dr. Lin says.
However, follow-up surgery may be needed in the future depending on healing, Dr. Lin says.
Will My Breasts Sag Again?
This is a common question patients ask Dr. Lin. “Certainly, with significant weight fluctuations again or pregnancy, skin and supportive tissues can further stretch. In absence of those things happening, the descent, volume loss or amount of stretch will not advance to the same degree as it was before,” he says.
How to Prevent Saggy Breasts
Some causes of saggy breasts are out of your control, such as genetics or the natural effects of aging. However, there may be some steps you can take to reduce drooping breasts:
1. Wear a Bra
This is somewhat controversial because there's not good data behind this, as designing a study around this is surprisingly challenging, Dr. Lin says. However, wearing a bra for support, including during sleep, may help, as long as it doesn't cause you to lose sleep, he says.
Similarly, wear a sports bra to limit breast movement during exercise, including when walking.
2. Maintain a Consistent Weight
Preventing significant weight fluctuations can help prevent the changes to breast size that result in sagging. In other words, aiming to maintain a healthy weight throughout your life lowers the risk of sagging caused by weight changes.
3. Perform Chest Exercises Regularly
Maintaining strong chest muscles can help support your breasts.
4. Don’t Smoke
Consider this one more reason to avoid the habit altogether or seek the support necessary to quit.
Is This an Emergency?
- Memorial Sloan Kettering Cancer Center: “Anatomy of the Breast”
- American Society of Plastic Surgeons: “Breast Lift”
- American Society of Plastic Surgeons: “How much does a breast lift cost?”
- Journal of Sports Sciences: “Supported and unsupported breast displacement in three dimensions across treadmill activity levels”
- Annals of Plastic Surgery: “Breast ptosis: causes and cure”
- Aesthetic Surgery Journal: “The effect of breastfeeding on breast aesthetics”