SEE VIDEO BELOW
This is commonly an optical illusion. A sagging breast appears larger whereas a lifted breast of the same size often appears smaller. This is one of the reasons that most mastopexy (breast lift) procedures are performed wtih breast implants. Patients commonly request the fullness of the upper breast that is associated with larger breasts which can only be achieved via use of an implant.
I have attached a video of a pateint who had a lift with no reduction and no implant. The breasts do appear smaller, when in fact, they are not.

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