In general, breasts sag because they're going to sag not because of anything the patient did such as working out or wearing a bra (or not). The main causes are hormonal fluxes such as during pregnancy, rapid weight changes, and genetics with genetics being the most important factor. There is currently no way to know if this is going to happen, when, or to what degree. It is also not possible to prevent it or give back lost tissue tone. Creams or pills to prevent or treat this are just advertising hype, wishful thinking, and a waste of money.
In over 26 years experience and thousands of cases, it is also my opinion that breast implants do not cause breasts to sag nor do they prevent or reverse it. Even a lift procedure does not restore tone to the tissues, give forward projection, or prevent it from sagging further. It is possible for the tissues to stretch around an implant and give the appearance of droop or "bottoming out" but this is not the same as ptosis of the breast (drooping).
Often a breast looks droopy because of volume loss and scalloping of the upper pole of the breast. This is not true droop and can be restored with implant volume. The way to measure true droop of the breast is to look from the front and see where the nipple-areola sits in relation to the crease under the breast. If the nipple-areola is below the line of the crease behind it then it has truly drooped. If the nipple-areola is at or above the crease level then it has not drooped significantly. Breast implants can only compensate for droop up to a point. They do not lift the breast and a nipple-areola position lower than about two centimeters below the crease line is too low to be filled out with an implant alone.
