Lift or Implants for Breasts That Flatten While Lying Down?

I am 18 years old and have large, spread out breasts that are not fully droopy, but sag some. When I lie down, they spread out towards my armpits and appear flattened. Would a breast lift solve my problem or would I need an augmentation? I am worried that a lift will not keep my breasts perky while lying down.

Doctor Answers 12

Breast Surgery for 18 Year Old?

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Thank you for the question.

Breasts “flattening while lying down”  does not seem to be enough of an indication to proceed with breast surgery. You may want to visit with well experienced board-certified plastic surgeon to discuss your concerns and goals in more detail. This will be the best way to receive meaningful/ accurate advice.

Although you may be a candidate for breast lifting/reduction surgery, there are many things to consider at your age especially.

Breast lifting procedures are associated with scars on the breasts;  exactly where these scars will be located will depend on the patient's physical examination and specific procedure performed.   Ideally it is best to do this procedure when you completed pregnancies and are a long-term stable relationship.

Most patients undergoing this procedure at the right time in their lives will accept scarring as long as their overall goals in regards to size, shape, contour and symmetry are met. 

Best wishes.

Need a photo

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I would need to see a photo to see what would work for you. You may need a breast lift if your nipples hang below your inframammary crease, or implants alone if you just want your breasts to remain more upright when lying down. However, you should know that natural breasts have a tendency to do that.

Breast fall flat when lying down

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It is normal for breasts to fall off to the side when you are laying down.  In order to know if you could get any improvement with breast surgery a photograph and measurements would be needed.  

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 20 reviews

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Breasts flatten when lying down

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It is completely normal for the breast to flatten out and "go to the side" when you lie down. It happens to everyone.  It's impossible to determine whether you need a mastopexy or implants without a photograph. 

Breast Lift vs Breast Augmentation

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Larger breasts that aren't "perky" are due to skin tissues that are less elastic and thus have less tone. If the nipple areolar complex is anatomically in the correct location, at or slightly above the inframammary fold (crease), then it's more likely you'll need an augmentation. However, to reduce the amount of excess skin a circumareolar removal of skin may be needed in addition to an augmentation.

Normal breasts will fall to the side when lying down

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The normal or natural breast will fall to the side when lying down, even after a breast lift or mastopexy. When on your back the breast size is minimized by this effect and It has always been one of those rules of thumb which has been passed down, that you can never really tell how big the breast is until the woman stands up; common knowledge to most beach goers. It has also been common knowledge to beach goers that in women with augmentations, the breast will stay up on the chest when lying down. This should give you something to ponder next time you get beach time in.

If you wish to be a fuller cup, certainly consider a breast augmentation, however at present your breast are perfectly normal.

Best of luck,


Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 44 reviews

Breast lift vs. implants

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Without examining you, it would be difficult to state specifically what would help you.  If your breasts are relatively flat and poorly shaped, implant surgeyr may help. If they sag, then a breast lift may help.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Lift, implants, both or reduction

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What you are describing could be one of many things. It would be best to be seen by a plastic surgeon and let him evaluate you, you tell him what you feel is the problem, what you would like to see and he can advise you. Indeed, you may just need some reassurance that all is normal.

John P. Stratis, MD
Harrisburg Plastic Surgeon
4.5 out of 5 stars 37 reviews

Breast lift

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It is difficult to give you a complete answer without a consultation. But from what you describe your breasts are reacting appropriately to changes in position. If you have larger breasts, then when you lay down your breasts will go to the sides. This is completely normal. A breast reduction or lift - depends on your exam - will help some but will not eliminate the issue you are concerned about. Getting implants will make it worse as you will be larger. Most likely you do not need any surgery. If you are still concerned, consult with a board certified plastic surgeon who can do an exam and give you a final answer. Just remember that sometimes having no surgery is the answer.

Bahram Ghaderi, MD
Chicago Plastic Surgeon

Breast lift and or augmentation

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A picture would help but if the breasts are not droopy when standing then you do not need a breast lift. All breasts will go out laterally when lying down. If you have the volume which it sounds like you do then an implant will probably not help. Consider a better bra to work with what you have. 

Sharon Theresa McLaughlin MD
Long Island City Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.