How to fix large, sagging breasts?

Question

I am 5'6 and 135 pounds. I have a very small bone structure and currently wear a 34F (us size). My breasts are very soft and hang. I am wondering if there is a way to do a lift where I will still have volume on top of the breast. Even if my bra fits, there is so much extra skin on top it looks like I have a double boob.

Jed H. Horowitz, MD, FACS · Answer

Candidates for Breast Lift (#Mastopexy) surgery are women who have #saggingbreasts due to past pregnancies, genetics, or aging. Often times the sagging is too great to be treated by implants alone. Women with asymmetric or enlarged nipples or areolae (pigmented areas around nipples) also may be candidates for a breast lift or a modification of a lift. #Asymmetric breast can be adjusted by adding or removing volume. One side can be tightened more or less than another. A mastopexy or breast lift operation is designed to improve the shape and position of the breast without reducing their size. It is used for breasts which sag or droop (ptosis). Sagging of the breasts may occur with normal development for some women, or as part of the aging process. Pregnancy, breast-feeding and weight loss are other conditions which increase breast ptosis. Some patients will have a better shape to their breast such as increased superior fullness if an implant is used at the time of mastopexy. The procedure can also be combined with a minor breast reduction to reduce the breast width if desired. The surgery will create an elevated, more youthful breast contour. Also, the procedure will create nipple and areolae of the desired size and at the correct height. I prefer to use a #shortscar technique, #LollipopScar or #DonutLift” rather than the majority of surgeons in the United States that use an anchor pattern lift which involve more significant scarring.

Kenneth Hughes, MD · Answer

In most cases, a vertical lift has the potential to help a great deal without the complete anchor incision, but pictures or an exam would be necessary to make a determination.

Randal Haworth, MD, FACS · Answer

Thanks for your question. Based on your description of your desired surgical outcome, I would suggest a breast augmentation with a small implant to restore upper pole breast volume in conjunction with a lift to improve perkiness and nipple position. Find a board certified plastic surgeon who specializes in breast surgery to have an in person consult with. Make sure to look at before and after photos of patients with similar anatomy and then you can collaborate with your doctor on the best individual surgical plan.

Gary Lawton, MD, FACS · Answer

Based on these photographs you appear to be an excellent candidate for a breast lift.  I would suggest that you will not get the position shape and symmetry that you would like with a limited lift.  A full anchor lift would be appropriate.

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

Gary M. Horndeski, MD · Answer

It would be interesting to see your actual photos to see if you qualify for The Horndeski/Bellesoma Method breast lift. I've included a short video so you can see what can now be achieved without the vertical incision and without the extra cost, maintenance, risks and complications associated with breast implants. Women who are thin like yourself and have large sagging skin do very well with this technique. I hope this helps. Best wishes and kind regards,

Thomas Trevisani, MD · Answer

Without a good set of photos- and the benefit of physical exam - it's difficult to give the best answer. Generally speaking, sagging breasts can be addressed with a mastopexy lift with or without implants- depending on the details of physical exam and patient's desires.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question.  The best advice you can
receive is from an in-person consultation. 
If you are an appropriate candidate for a breast 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

William Bruno, MD · Answer

This is difficult to answer without seeing photos but sounds like you would benefit first from a breast lift, then at a second stage (several months later) a breast implant for added volume at the top of your breasts. Consult with a few surgeons in person for a complete exam.Best wishes,Dr.Bruno

Edmund Ek, MBBS, FRACS (Plast) · Answer

From what you describe, you might consider a small implant to accompany your breast lift. This could give you the volume you desire. Without any photos or a thorough examination, there is no way for us to give accurate advice. I recommend you schedule a consult with a specialist plastic surgeon.

How to fix large, sagging breasts?

Answers (18)

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