I'm 23 years old. I have very saggy breasts. What's the best procedure to go about fixing them? (Photo)

Question

Leila Kasrai, MD, FRCSC · Answer

A breast lift reshapes the breasts to make them perkier in appearance. This may be the procedure to consider for you, since it’s the sogginess that you’re concerned with. If you’d also like to reduce the size of your breasts, then a breast reduction can also be performed at the same time.

Daniel Barrett, MD · Answer

Hi kpalmer611,
  
Determining whether you need simply a breast implant versus a breast lift or both can be somewhat complicated. It depends on a number of factors including skin laxity and current nipple position. 
  
Generally speaking, if the nipples are lower than the inframammary line the patient will most likely need a breast lift. If the nipples are at or above the inframammary line we can generally get by with just breast augmentation depending on the size of the implant the patient wants. I often use an implant when I perform a breast lift because it provides more upper breast fullness after the lift. Also, price range for breast lift is around 10k to 15k depending on whether you need a lollipop or a donut mastopexy.
  
Another important consideration to make would be the breast implant type and sizing selection. In fact, this is a complicated process and requires a detailed consultation that includes a discussion of your goals, a detailed examination, and a lengthy discussion. But the decision will always start and end with the patient.  
  
When it comes to sizing, we have all of our patients find 3 photos of their desired breast size. We ask for naked breast photos because clothing can obscure the true size (push up bras). Next, we consult with patients and go over the photos and take detailed breast measurements during a physical exam. Next, we using a sizing algorithm to determine a range of implants that will work based on the exam and the measurements. 
  
Lastly, during the operation, we use silicone sizers in the operating room to see how the size actually looks in the breast. We sit the patient up in the operating room, while asleep of course, and compare the sizer result with their desired look photos. If it is too small, we start the process over with a slightly larger implant. We don't stop until we get the perfect match. 
  
Of all of my breast augmentation patients, every one of them has been happy with their size due to this detailed and meticulous process. You don't want to invest time and money into a result that is either too big or too small.
  
You should discuss your concerns with a board-certified plastic surgeon and make sure that your surgeon understands your goals. 
  
Daniel Barrett, MD, MHA, MS
  
Certified, American Board of Plastic Surgery 
  
Member, Am. Society of Plastic Surgery

Jaime S. Schwartz, MD, FACS · Answer

I appreciate your question.
  
I perform a liposuction breast lift that removes tissue from the areas you don't want such as near the armpit and the lower portion hanging near your stomach. Once I use this to shape the breast I then remove the skin to tighten the breast and create a better shape with nice cleavage. Since I perform this less invasively the recovery time is faster and drains are not necessary. The size would depend on the proportion with your body versus going for a cup size. It works very well if there are asymmetries. I can also use the removed fat as a natural breast augmentation by grafting the fat back into the breast to create more projection or into the top to create more cleavage. This procedure can also be combined with an implant if needed or wanted.  It should not affect nipple sensation, mammograms, cancer risk or breast-feeding. If you gain or lose weight, the transferred fat can do the same.
  
The best way to assess and give true advice would be an in-person exam.  Please see a board-certified plastic surgeon that specializes in aesthetic plastic surgery.  
  
Best of luck!    
  
Dr. Schwartz 
  
Board Certified Plastic Surgeon
  
#RealSelf100Surgeon 
  
#RealSelfCORESurgeon

Urmen Desai, MD, MPH, FACS · Answer

I recommend an implants and lift.  The implant selection should be based on a combination of your desired size, soft tissue dynamics, breast base diameter and skin elasticity.  I recommend an in-office examination as well as a detailed discussion with a surgeon who you are comfortable with.   Finally, make sure your surgeon is a Double-Board Certified Plastic Surgeon certified by the American Board of Plastic Surgery (ABPS), a member of the American Society of Plastic Surgery (ASPS), a member of the American Society of Aesthetic Plastic Surgery (ASAPS), and a fellow of the American College of Surgeons (FACS).Best,Dr. DesaiBeverly Hills Institute for Aesthetic Plastic SurgeryBeverly Hills & Miami Beach TrainedDouble Board-Certified Beverly Hills Plastic Surgeon

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your photograph, you are a
great candidate for a breast lift/reduction.  This can be designed to result in an
improved shape and contour of your breasts while minimizing scar
appearance.  Make sure you specifically look at before and after
pictures of real patients who have had this surgery performed by your surgeon
and evaluate their results.  The most important aspect is to find a
surgeon you are comfortable with. I recommend that you seek consultation with a
qualified board-certified plastic surgeon who can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Harry T. Haramis, MD, FACS · Answer

A breast lift will improve breast shape and appearance. It can also make them more even.An exam and consultation with a plastic surgeon is recommended to discuss your options and expectations.

Scott W. Vann, MD, FACS · Answer

You do have significant sagging with your nipples well below your breast fold. A breast lift would elevate and reshape your breasts as well as position your nipples on the center of the mound. If you feel they are a bit too big a small reduction could be done at the same time Good luck.

Jon Kurkjian, MD · Answer

Thank you for your question and photos
There are several variables to be considered when answering this question. It is always difficult to make a diagnosis based on photos alone, however, you do appear to be a good candidate for a breast lift with implants. When you meet with a board certified plastic surgeon, they will perform a set of measurements that will help determine whether or not a lift is necessary and what approach they will take. This will determine the type of incisions you will have. Another variable that needs to be discussed is what you are wanting. If you are wanting a fuller upper pole to your breast, then an implant will be necessary.  If you are just wanting the breasts to be a little perkier and don't mind the size, then only a lift is necessary. And to have the nipple in proper position over the implant, may require a lift. I hope this is helpful

David P. Rapaport, MD, FACS · Answer

To improve the appearance of ptotic, or saggy, breasts, I would recommend a breast lift surgery.  This procedure would raise your breasts up and remove any excess skin that contributes to the saggy appearance of your breasts.  To discuss the surgery in detail along with the risks and scars, consult with a board-certified plastic surgeon who specializes in breast surgeries.

Tania Medina de Garcia, MD · Answer

Hello dear, Thanks for your question and provided information as well..
The breasts may lose their elasticity and firmness which can be caused bydifferent factors such as pregnancy, massive weight loss, lactation and aging.To reaffirm the breasts and restore the natural look your surgeon can perform amastopexy or breast lift.Abreast lift restores a firmer, perkier, and more aesthetically pleasing shapeto sagging breasts. This not only can improve a patient’s appearance byrestoring her youthful, feminine proportions, but also help bras andswimsuits fit more comfortably and attractively. By removing excess, stretchedout skin, reshaping the breast tissue, and raising the nipple & areola intoa more forward position, a cosmetic surgeon can create a more youthful breastcontour. Stretched, large areolae can also be reduced during breastlift surgery, creating an overall better proportioned, natural looking breast,your surgeon will determine on a personal consultation how your scar’s going tobe and where depending on your breast tissue amount, I suggest you to checktesters with your surgeon about sizes and type of implant. Hope this is helpful. Good luck.-