Why Have my Breasts Shrunk After Having a Baby and an IUD?

Question

I have always been large chested since high school. I am 21 years old and my breasts never fluctuate with my weight. However, after having my baby I went on an IUD. I've been on it for about a year and have noticed a significant decrease in my breast size, firmness, and they are now uneven. I work out frequently and am smsller than begore pregancy but as indaid weight loss nevet influenced this before. What caused this and how can I fix it?

Paul Vitenas, Jr., MD · Answer

Breast size changes are unpredictable during and after pregnancy but usually they get larger. Following delivery or breast feeding many times the breasts will get much smaller leaving hardly any substance in some cases. The IUD has nothing to do with your breast changes.

Sultan Hassan, MD, FRCS(Plast) · Answer

After pregnancy, your body will slowly 'normalise' after the hormonal changes of pregnancy have abated. This effect will be prolonged and potentially exacerbated by breastfeeding. Breasts are made up of a mixture of glandular breast tissue and fatty tissue. The fatty component may change with your weight fluctuations and the glandular component will be subject to hormonal influences such as various different types of contraceptive pill and iucd. You should see a plastic surgeon for assessment of your breasts.

Brian K. Reedy, MD · Answer

Unfortunately, what you are experiencing is what the large majority of women undergo after pregnancy. It is a natural process called involutional ptosis that occurs after pregnancy and more so after breastfeeding. It tends to get worse after each subsequent pregnancy. It is a loss of breast volume and elasticity of the skin. The solution is breast augmentation and sometimes breast lift.

Lewis Albert Andres, MD · Answer

This is an excellent question, and one very common for those seeking rejuvenation of the appearance of her breasts, especially after pregnancy.  Your complaints are likely due to post-pregnancy changes of your breasts as they likely enlarged and stretched during and immediately after your pregnancy as they became engorged with milk for lactation.  Now, they have a typical "deflated" appearance as they have settled but have lost much of the enlargement during your pregnancy.   

	Options to ameliorate your complaints would include implant placement, breast lift, fat grafting, or a combination of these modalities.  A consultation with a plastic surgeon may help you decide which procedure(s) may be the best option for you.  

	It may be wise to wait until after you have completed child bearing, as similar changes will occur after each pregnancy.  Also, it is not uncommon to have different sizes of breasts, but I would recommend evaluation if there is a sudden change in one side from another, a mass is felt to account for the size difference, any changes in skin or nipple appearance, or drainage/bleeding from the nipple.  Thank you for your question.  Hope that these answers help!

Shim Ching, MD · Answer

Dear EnMich13,

	Thank you for your question.  Women often will experience a shrinkage of their breasts after pregnancy.  After a period where your breasts were larger and preparing for breast feeding, The glandular tissue (the portion of the breast responsible for milk production) of the breasts will often shrink in size.  This causes drooping of the breasts and a deflated appearance.

	Breast implants can fill out your breasts again and give you more youthful breasts.  If the amount of drooping and loose skin is greater, you may require a breast lift to restore your breasts to how they used to look.

Michael Horn, MD · Answer

Many women find that the breasts get smaller after pregnancy. The good news is that your size and shape can be improved with implants. If you experienced severe sagging, a lift along with the implants will make a nice shape.

Kenneth Hughes, MD · Answer

Breasts tend to involute after pregnancy and/ or breast feeding for the most part. To regain the volume, breast augmentation with implant is probably the best option. If the breasts are uneven in size, implants will help. If they are droopy as well, a lift will be necessary. Kenneth Hughes, MD Hughesplasticsurgery Los Angeles, CA

Norman Bakshandeh Day, MD, FACS · Answer

You have what a lot of women experience after pregnancy. This is called post parum involution of the breast where the skin volume expands and the breast volume relatively seems smaller.

Richard J. Brown, MD · Answer

Fortunately you are experiencing what most women experience after childbearing and with age so this is nothing out of the norm. You are witnessing the effects of pregnancy. Breasts go through what is called involutional ptosis and hypoplasia. When the milk fills the breast they swell and stretch greatly. Then when you are done breast feeding you are left behind with stretched out skin. The tissue of the breast also will shrink and the quality changes from firm to soft. With age breast tissue becomes more like fatty tissue and not firm glandular tissue. Your IUD has nothing to do with the changes. I see patients every single day with your story. Usually to rejuvenate the breasts a patient will require either breast augmentation, breast lift or a combination of both.

Parviz Goshtasby, MD, FACS · Answer

Hi EnMich13! Your concerns stem from the fact that the breasts are highly specialized endocrine glands that significantly respond to fluctuations in weight and are very sensitive to hormonal changes, especially during puberty and pregnancy. With weight loss or gain, usually all areas of the body respond proportionally to this change, although some women genetically tend to lose or gain more mass in certain areas of their bodies, whether it is their hips, love handles, or breasts. Your exercise and weight loss, although healthier for your heart and body, can lead to a significant reduction in your breast size. In addition, substantial fluctuations in hormone levels during puberty and pregnancy can lead to rapid growth of the breast tissue and ducts, sometimes asymmetrically, leading to a condition called juvenile breast hypertrophy or gestational breast hypertrophy, respectively. The usual culprits are a large surge of prolactin, estrogen, and progesterone levels during these events for which some women's breasts are more sensitive to these changes than others due to increased hormone receptors or genetic factors. After puberty or pregnancy is completed, hormone levels usually return back to normal levels, which leads to breast volume deflation with reduction in size and occasionally ptosis (sagging). My guess based on your description is the significant changes in your hormone levels from completing puberty and pregnancy, followed by further weight loss from exercise has led to the loss of volume and firmness of your breasts. I am not aware of IUDs by themselves leading to loss of breast size, although the cessation of monthly periods from use of some IUDs can negatively affect your monthly hormonal cycles, which can secondarily affect your breast volume. The best way to regain your breast size, short of gaining weight or becoming pregnant again, would be to consult your local board-certified plastic surgeon for breast augmentation with implants +/- breast lift. Although fat stem cell transfer research looks promising, it is still experimental at this time and would only lead to a modest increase in volume. Hope that helps!- Dr.92660.

Why Have my Breasts Shrunk After Having a Baby and an IUD?

Answers (17)

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