Breast sagging at 19. Any suggestions? (photo)

Hi there, I have been struggling with breast ptosis since I started puberty, but after losing weight I have noticed they have lost even more volume. Would I be able to fill with an implant or would I need a lift as well? I would like a nipple reduction so would that be enough to lift it?

Doctor Answers 17

Sagging at 19?

The angle of the photo you posted is not great, but from what can be seen it looks like you may need a lift. Losing a significant amount of weight could make the problem worse. An implant can provide volume but it doesn't truly lift your breast. It doesn't really seem fair that one might need a breast lift at age 19, but I just finished doing a lift today on someone who was only 20, so it can happen.

Breast ptosis at age 19.

The angle of your photograph is very limiting but it appears that you are a candidate for enhancement of volume by placement of a breast implant probably accompanying either a periareolar Benelli lift or possibly a more aggressive uplift such as a lollipop lift or full mastopexy.  You need a face-to-face examination with an ABPS board-certified plastic surgeon to determine your options and set preferences.  Good luck and best wishes and please enjoy the video link above for more information about uplifts and implants.

Jon A Perlman M.D., FACS
Diplomate, American Board of Plastic Surgery
Member, American Society for Aesthetic Plastic Surgery (ASAPS)
ABC-TV Extreme Makeover Surgeon
Beverly Hills, California

Jon A. Perlman, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 29 reviews

An exam is required

for you to get the answers you seek as you will have the opportunity to let your surgeon know of what your expectations are as it will determine what procedure is recommended.  I have a bias against lifts at such a young age due to the scarring and potential impact it may have on your ability to breast feed down the road but you can choose once you know what the risks are and are accepting of them.

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 32 reviews

Breast implant vs implant with a lift

Thank you for the question. 

The image that you have provided makes it difficult to give an accurate opinion regarding what you need.

If the nipple and areola is at the level of the fold, a breast implant will correct the volume loss and shape. 

If the implant is slightly low, an implant and an internal lift will likely provide a significant improvement with no additional incisions on you breast. 

If you are slightly more ptotic, an implant and a Binelli mastopexy will provide a great result.

There are many well trained and very experienced CSAPS / ASAPS member PS in Vancouver.  Please make an appointment and visit one or more of them to get a full consultation.  After you are fully informed, you will be able to decide who you want to chose to help you with the life transforming change.

All the best,

Scott K. M. Barr, MD, FRCSC, Plastic Surgeon, Ontario, Canada

Scott Barr, MD
Sudbury Plastic Surgeon
4.8 out of 5 stars 37 reviews

Breast sagging at 19. Any suggestions?

It's difficult to tell from your photo, but it does appear that you would require a breast lift also. A lift is added to a breast augmentation when there is significant ptosis. Of course an in person examination will be most helpful. You be able to have a conversation with a surgeon about the pros and cons of adding an implant, what can be expected from only a lift, and when there may be benefit to performing a lift as a first stage and then adding an implant only if needed.

Breast sagging at 19

Thank you for your question. Even without an optimal photo, it is clear that you don't have the high, youthful breast position that you desire. You appear to have adequate volume to reshape to a higher position with either a breast lift (mastopexy) or cosmetic reduction technique. I recommend that you discuss your options with an experienced board-certified plastic surgeon in your area. The consultation is about getting information to make the best informed decision for you as an individual. Don't hesitate to have more than one consult if you need additional information before proceeding. Best of luck to you.

Michael F. Bohley, MD
Portland Plastic Surgeon
4.9 out of 5 stars 15 reviews

Breast lift and augmentation considerations #plasticsurgery

I'm sorry that you are struggling with your breast appearance. An in-person examination is important to make these decisions - but in general terms, a breast lift with removal of sagging breast tissue and augmentation with a reasonably sized smooth round silicone implant has been my go-to cosmetic breast procedure for patients with your type of breast anatomy.

Breast sagging at 19. Any suggestions?


It is difficult to tell from the angle of your photos, but from what I can see and the fact that your primary complaint is breast ptosis, the best treatment for you would likely be a breast lift, or mastopexy. This would reshape the contour of your breasts while lifting the nipple and areola into a more youthful and higher position. The goal of a breast lift is to maintain as much desired volume as possible while removing excess skin to tighten the outer envelope (skin) relative to what's inside (breast tissue). The trade is contour for scar. These scars tend to heal very well and the type of scar would depend upon the type of lift you'd benefit from. This should be decided by you and a well trained plastic surgeon.

If you are happy with the volume of your breast while in a bra and do not wish to have upper pole fullness (that round "Victoria's Secret" look), a lift alone may meet your expectations. If you would like more volume in your breasts, meaning you would like to be bigger than you currently are in a bra, or if you desire more upper pole fullness, then an implant or augmentation would be required to achieve that.

The most important thing is to have an open dialogue with a well trained plastic surgeon who listens to your goals and objectives and offers only the necessary surgery to achieve that.

I hope this helps. Good luck with everything!

Joseph Brown, MD
Tampa Physician
5.0 out of 5 stars 6 reviews

Breast ptosis is normal and sometimes bothersome for many women of different ages

After significant weight loss it is common for the breast to look deflated. Tightening of the breast skin appears to be needed but only with a consultation can the recommendations be made more specific. Most patients with your features would benefit from a modest augmentation combined with a vertical breast lift requiring a lollipop final incision placement. If your features are conducive to circumareolar (doughnut) lift then the vertical scar would not be necessary. Furthermore at age 19 you need to have a good understanding about the implications of various implant types available and how to minimize your risks for future surgery.

Best regards,

Mathew C. Mosher, MD
Vancouver Plastic Surgeon
4.7 out of 5 stars 32 reviews

Breast sagging at 19. Any suggestions?

It isn't possible to tell from your angled photo whether a lift would be helpful. Lifts make the breast look younger but not bigger. Implants make the breasts look bigger but don't do much lifting. Reducing the areola can lift the areola but not the breast. Why not see an experienced surgeon in consultation and then you will have your answers. 

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 24 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.