What should I do? (Photos)

I have naturally big breasts (42DD). But as I got older and gained weight rapidly my breasts began to sag. I now feel uncomfortable in clothes other than a sweatshirt and sweatpants. I want to feel comfortable again. I'm hoping to make my breasts a little bit perkier. Please help.

Doctor Answers 7

What should you do?

Also known as reduction mammoplasty, this is an operation intended to reduce the size of a woman's breasts and improve their shape and position. Frequently, the areola (dark skin around the nipple) is also made smaller. Functional symptoms (medical disorders) caused by excessive breast weight may be relieved or improved by this operation. Breast reduction procedures are ideal for:

  • Women who have large, heavy breasts, which may be the cause of movement difficulties, back, shoulder and neck pain, poor posture, bra-strap indentations and chafing under the breasts will benefit from reduction.
  • Women with excessive breast size, which may decrease a sense of attractiveness and self-confidence, are candidates.
  • Women with large breasts that interfere with normal daily activities or with exercise will be more comfortable when reduced.

What to do

Your breasts appear to sag as well as be different in size. The procedure to undergo depends on what size you want to be, however you will need removal of some breast tissue to correct the disparity. It sounds like your breast size changed with weight gain, therefore, if p[lan to lose weight, hold off on the surgery since your breast size will change.

Barry M. Schwartz, MD
Weston Plastic Surgeon
4.0 out of 5 stars 4 reviews

Breast reduction, some advices:

Thank you very much for sharing your concerns with us. 
After having analyzed all the information provided to us, i can realize that you have very large breasts for your height and weight, and can be responsible for head, back, neck and shoulder pain.

In the future may cause  permanent osteo-articular damage in the back and shoulders and skin problems (mainly under the breasts). For for this reasons, certainly you need a breast reduction surgery.

Kind regards

Emmanuel Mallol Cotes, MD
Dominican Republic Plastic Surgeon
4.7 out of 5 stars 174 reviews

Lift and reduction

It looks like you might benefit from the breasts being lifted and a reduction of the overall volume. Best to be seen in person.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

Breast lift vs reduction

Hello and thank you for the question and the photos. Your photo shows sagging or ptosis of the breast. I would suggest a full mastopexy using the anchor type incision. This will give you the best ability to lift and reshape the breasts. If you want them to be a little smaller, a conservative reduction would work as well. 

The surgery takes about 2 hours under full anesthesia (can't do this awake ) . It is performed in an outpatient surgical center. In our center, the fee is 7k for a breast lift. This includes anesthesia, surgery center, doctor fees, and follow up visits. 

I would normally recommend patients taking 1 - 2 weeks off of work and about a month out of the gym.

You should have several consultations with board certified plastic surgeons in your area before proceeding. 

As always it is best to be healthy, no smoking, and if you have any health problems they are under the current management of your primary care physician.

Best to you

Bennett Yang, MD
Rockville Plastic Surgeon
4.8 out of 5 stars 16 reviews

What should I do?

A breast lift, perhaps with a small reduction, would give a nice result. See link below for examples. 

Karol A. Gutowski, MD, FACS
Chicago Plastic Surgeon
4.9 out of 5 stars 65 reviews

What should I do?

I am sorry to hear about the problems your disproportionately large breasts have caused.  Based on your description, you may be an excellent candidate for breast reduction surgery; this tends to be one of the most patient pleasing operations we perform. Ideally, you will be as close as possible to your long-term stable weight prior to proceeding.


“Typical” patients who present for breast reduction surgery are women who have disproportionately large breasts, causing problems such as neck/back/shoulder discomfort, postural changes, bra strap grooving, skin irritation/rashes under the breasts, and/or difficulty with activities of daily living and/or exercise etc. There may be both physical as well as psychosocial “stress” caused by the disproportionately large breasts.


Reducing breast tissue mass and elevating the breasts on the chest wall tend to improve or alleviate many of the symptoms associated with the disproportionately large breasts.



Patients considering breast reduction surgery should also consider the potential downsides (risks/complications) associated with the procedure as well. Poor scarring, for example may be associated with the procedure. Additional surgery may be necessary in the short or longer term for a multitude of reasons.



When the time is right, I suggest that you seek consultation with well experienced plastic surgeons who can demonstrate significant experience achieving the types of outcomes you would be pleased with. Ultimately, careful selection of your plastic surgeon will be the most important decision you make.

To this end, I would suggest you visit a few surgeons whose practices concentrate on aesthetic surgery. Ask to see lots of examples of their work and preferably speak/see patients who have had similar procedures done. 

I hope this, and the attached link (dedicated to breast reduction surgery concerns), helps. Best wishes.


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.