20 Years Old and Sagging? (photo)

   If you are happy with your size, a breast lift can lift the breasts and reduce the areola size if that interests you.  Find a plastic surgeon with ELITE credentials who performs hundreds of breast lifts each year.  Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results.  Kenneth Hughes, MD Los Angeles, CA

Hi kristinaM,

     You have a certain degree of breast ptosis (droop). If you're looking to have your breast lifted so that the nipples are at a higher position, the breast no longer sits on your chest wall, and your areolas made smaller, then you would require a breast lift.  Usually woman of your age are also looking for upper pole fullness and a better cleavage.  In my opinion that could only be achieved reliably with the use of an implant.  A lift with implants, known as augmentation mastopexy, is what you would most  benefit from.

     There are a number of lifts avaiable. In my opinion, the vertical mammaplasty technique is the one that produces the best results.   In this technique, the internal structure of the breast is reshaped and sutured together.   Although some of the excess skin is removed and sutured close.  Very little tension is placed on the skin.  This allows for better scars and the long horizontal scar under the breast can be avoided.  You will only require an incision around the areola along with a vertical one.  When possible, it is important to avoid a horizontal incision. It is the horizontal incision that most often heals poorly.

     To give you upper pole fullness and a better cleavage, an implant would be required. No lift alone, regardless of which technique used or how tight it is performed can achieve upper pole fullness.  An implant placed behind the muscle will be required to achieve that look.

Good Luck,

Ary Krau MD FACS 

You do have ptotic (sagging) breasts, just through genetics and development. This is not unique to women after pregnancy or weight loss. 

A vertical mastopexy, which is a breast lift with a circular incision around the areola and a vertical incision from the bottom of the areola to the breast fold would be my recommendation, based solely upon the photos posted. This will reshape the breasts, raise the nipples and areolas to a better level, and reduce the areolar size. 

When you are ready for an in person consultation, RealSelf has listings of surgeons in your area. You should consider cross referencing the listings from the The American Society of Plastic Surgeons (plasticsurgery dot org). A listing in the ASPS website assures you that your surgeon is not only board certified,  but also is a member in good standing of the major plastic surgery organization in the U. S. Thank you for your question, best wishes.