I Am 18 Years Old and Have Sagging Breasts. What is the Best Approach in Terms of Surgery? (photo)

My breasts have been flaccid and droopy ever since I could remember. I was wondering if they may be tubular. I've never lost weight or had any children so I don't know why my breasts look like this. My goal after surgery is to have perky lifted breasts that look natural.

Doctor Answers 12

18 and Sagging breasts

Breasts can be ptotic (sagging) even at a young age of 18. As mentioned, you have a tubular deformity of your breasts and have significant ptosis. I would recommend a breast lift and no implants at the first go. If you are happy with them you are done. If at some point you want to go larger then implants can be placed. There are innovative lifts that can be used to minimize scarring, bring symmetry and to fill in your upper pole. Good Luck.

Seattle Plastic Surgeon
4.9 out of 5 stars 48 reviews

Breast Improvement

Yes, you have  a form of tuberous breasts with base narrowing, large areolae due to so-called pseudoherniation of breast tissue, and ptosis.  I would do an uplift through a periareolar pursestring approach, score the constricted breast tissue to open it up, and place a small implant to increase your upper pole fullness to give you a nice, natural correction.  Hope this helps.

Peter J. Simon, MD
Fort Lauderdale Plastic Surgeon
4.7 out of 5 stars 3 reviews

Tubular/tuberous breasts

There are a number of features that define a tuberous breast:
•Wide and puffy areolae
•widely spaced breasts
•high breast fold
•constricted lower pole (deficient tissue in lower half of the breast
•minimal breast tissue
•high breast fold
•narrow base of the breast

Most of these are present in the photos you have been kind enough to share. 

If your breast size is satisfactory, a breast lift will improve the contour of your breasts. 

It the size is less than you see as a goal, a procedure combining implants and a lift would be advised. 

Either way, these procedures are more complex than they are on women without tubular breasts, and the possibility of  needing a touchup procedure after the first is there.

There are a number of features that define a tuberous breast:
•Wide and puffy areolae
•widely spaced breasts
•high breast fold
•constricted lower pole (deficient tissue in lower half of the breast
•minimal breast tissue
•high breast fold
•narrow base of the breast

Jourdan Gottlieb, MD
Seattle Plastic Surgeon
4.6 out of 5 stars 45 reviews

Sagging Breasts Improved with a Lift

     Sagging breasts can be improved with a lift.  If you would like the breasts to be larger, an augmentation can be performed simultaneously.

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 492 reviews

Sagging breasts

Sagging breasts can be treated by performing a lift. If you want larger breasts then you will need implants.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 28 reviews

Sagging breasts at age 18

Your breasts are considered fully grown by age 18 so it is reasonable to consider doing something for the size/shape. Future changes are unpredictable but include pregnancy changes, weight changes, hormonal effects, and aging. This is the same issues as for older women. 

I disagree with the responses that loss of breast feeding is a significant risk at least with a glandular pedicle technique for the lift but it's not possible to know if you haven't breast fed successfully already. 

Clearly you exhibit the large and "puffy" areolas that are part of the "constricted" or "tubular" breast but this is mainly an issue that wouldn't be corrected by an augmentation alone and your degree of sag (ptosis) is too great to consider an augmentation alone. 

I would recommend a full glandular lift with a lollipop type (vertical) incision and then see how things go with weight, pregnancy, etc. in the future. Remember that the skin or tissues are not tightened by a lift and that it's an illusion that your breast looks more "perky" even with an implant. A lift just moves the breast tissue up over its base and adjusts the skin envelope. An implant is just a pillow behind the breast base. I would also avoid fat grafting to the breast of an 18 year old at this time because it has not been well documented/proven that there is no change in risk of breast cancer or detection. 

Scott L. Replogle, MD
Boulder Plastic Surgeon
4.0 out of 5 stars 1 review

Breast Lift Surgery

Your photos show some drooping and sagging of the breasts which could be corrected with a breast lift procedure.  The result will be perkier and more youthful looking breasts of about the same size you have now.  If you would like to increase the volume of your breasts, implants will be necessary because a breast lift will only change the shape, not the size of your breasts.

Norman M. Rowe, MD
New York Plastic Surgeon
4.9 out of 5 stars 58 reviews

18 Years Old and Have #SaggingBreasts... ANS:

I think at some point you really could benefit from a full breast lift with an implant but the question is when. A full lift is a big operation for a young woman and there is the chance that you may not be able to breast feed afterward. So I think you are great candidate to get the result you are looking for but it is now a question of when!

John J. Corey, MD
Phoenix Plastic Surgeon
4.6 out of 5 stars 44 reviews

Sagging breasts on young patients

Thanks for sharing the photos. Your photos showed characteristics of mild tubular deformity and ptosis. If you are happy with current size and not wanting to go bigger, then all you need is breast lift with areola reduction. If you like to have fuller and larger breast volumes, then you need to add breast implants or autologous fat depending on how much bigger you wish to get. 

Best Wishes,

Stewart Wang, MD FACS, Wang Plastic Surgery

Stewart Wang, MD, FACS
Los Angeles Plastic Surgeon
4.6 out of 5 stars 28 reviews

Tubular breast deformity

You may in fact have some degree of a mild tubular breast deformity. I feel that a breast lift (vertical breast lift) will significantly improve the appearance of your breasts. However, if you wish to have more volume you will definitely require placement of an implant.

Kevin Brenner, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 22 reviews

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.