I'm forty years old and have no children. Not Happy with the Sagging. What is my Best Option? (photo)

I'm forty years old and have no children. I'm not happy with the sag of my breasts. I'm already large at 32 DD, so I don't think I need anymore volume, but I would love for them to be more round and full and higher on my chest. What would be the best option for me?

Doctor Answers 14

Breast lift

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Since you are happy with the size of your breasts, this would suggest that you will only need a lift. However, the more you lift the smaller the breasts will become since the tissue becomes compressed. In addition, a lift may not produce the exact shape that you desire, especially in terms of fullness higher on the chest. Some patients will need a reduction, lift, and augmentation to give them the shape and size they want.

Robin T.W. Yuan, M.D.

Beverly Hills Plastic Surgeon

Mini Ultimate Breast Lift is the best option for sagging breasts

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You may be an excellent candidate for a new procedure called The Mini Ultimate Breast Lift.  At size 32 DD it is possible to perform a breast lift with minimal reduction using ony an incision around the areola.  At surgery the sagging skin is resected around the areola and the breast tissue internally supported by the underlyling muscle.  This technique immediately relieves sagging without ugly vertical scars or boat anchor shaped incisions.  The only scar you would have would be around the areola and is easily hidden.

Best Wishes,

Gary Horndeski, M.D.

Gary M. Horndeski, MD
Texas Plastic Surgeon
4.6 out of 5 stars 230 reviews

Breast Lift to correct Sag

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You are a classic for a mastopexy (breast lift), especially at a "DD." The procedure elevates the breast, puts the nipple where it belongs and removes only the excess skin. Your size really does not change from where you are now in a bra. At your size, there is a chance that gravity will cause recurrence of some droop. However, with the newer vertical lift procedures, this can be minimized. The trade of is that it takes several months for the breast to assume its final shape.


Robert T. Buchanan, MD
Highlands Plastic Surgeon

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Options for sagging breasts of adequate volume

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Breast implants are only pillow or forward volume. If you have adequate volume then there is no reason to consider an implant as implants do not lift the breast and your breast looks too low to consider an implant alone. It is not feasible/reasonable to put a "small" breast implant in to fill the upper pole. Breast implants must be sized properly and positioned properly behind the breast. The minimum size increase is about one cup size.

A true breast lift (mastopexy) looks to be the appropriate procedure for you to reposition your breast higher along with the nipple-areola and tuck the lower part of the breast up (but not held up by the skin). The technique for lifting the breast is separate from the incision type but a true breast reposition in your case would be best done with a lollipop-type incision.

Properly lifted breasts actually look bigger, not smaller, but this is an illusion just like the illusion that a breast implant actually lifts the breast. The drawback to a lift is that it does not "firm" the breast. It does not give it forward projection. It does not fill in the upper pole of the breast although it can look more balanced or a shorter scallop. It does not depend on "luck". The trade-off is the incisional scar. 

Fat injections into the upper pole of the breast would solve the scallop problem with minimum increased volume, but there is no established best way to do this and there is no long term data to prove that fat transplanting (or stem cells) has no impact on breast cancer incidence and/or cancer detection. It is currently not recommended for cosmetic purposes in the breast.

Scott L. Replogle, MD
Boulder Plastic Surgeon

Help with sagging breasts

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In your case you will most likely need some type of lift procedure (either full mastopexy or lollipop).  With a lift procedure your breasts will be "perkier" and sit higher on your chest but you will still have a natural slope to your breasts unless you add an implant.  If you did a lift with a small implant you should end up with the same bra size but your breasts will be perkier and fuller on the top.  Now that is all being said without examining your breasts and taking measurements.  I would highly recommend you see a board certified plastic surgeon who performs a lot of breast lifts with augmentation prior to scheduling any surgery.  Best wishes!!


Milind K. Ambe, MD
Orange County Plastic Surgeon
4.7 out of 5 stars 52 reviews

Sagging breasts

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In my opinion, a vertical lift with a small implant, saline or silicone.  this will create upper fullness of the breasts and witha relatively conservative size implant, about 275 or 300 cc's , your breasts will be a nice shape without appearing excessively large.

Ronald J. Edelson, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 31 reviews

Happy with size, breast lift should do

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If you are happy with your breast size then a breast lift alone will firm and lift the breast higher. The rounder upper fill however comes from an implant, even a small one to reduce the hollow scoop which can occur after breast lift. The vertical lift is the best way to start without an implant if you are concerned about volume.

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


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Without actually seeing you in person and examine you it’s hard to be exact. It sounds like you’re happy with your breast size. In our practice in your situation you have a few different options. You can get a lift by itself to lift them, but you will still have a slope on top of your breast. You can do a lift a Lolli pop (vertical Lift) lift with a modest implant just to give you superior fullness and make them pickier. The implant will not be to make you bigger but you uplift you and give you fuller breast.  You need to go see a PS for a consultation to review your options.


Stuart B. Kincaid, MD, FACS (in memoriam)
Beverly Hills Plastic Surgeon

Sagging Breasts Can Be Lifted

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A breast lift that rearranges the fullness you have at the bottom up top the top will give you a fuller, more rounded look without an implant.  My preference is to do this using a lollipop shaped incision.



John LoMonaco, MD, FACS
Houston Plastic Surgeon
5.0 out of 5 stars 276 reviews

Lejour vertical breast lift with lollipop scar is best for most women.

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 You look like a great candidate for this procedure, which produces long term perky breasts.  Breasts do not get smaller with a good breast lift.

George J. Beraka, MD (retired)
Manhattan 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.