Sagging Breasts: How to Perk Things Up

after babies and i guess aging :( my breasts sag more than i'd like. is breast lift or plastic surgery my only option for getting them perked up again?

Doctor Answers 162

Improving sagging breasts with mastopexy

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An unavoidable consequence of aging is the loss of elasticity, or tone, in skin and soft tissues. This process, which may be compounded by changes, which occur during and after pregnancy, will ultimately lead to 'drooping' of the breasts. A variety of surgical breast surgery techniques can be used for restoring the breasts to a more youthful position and shape. The goal is to both relocate the nipples to a higher position, and to restore breast projection (and to maintain projection for the long term).
Having abreast lift operation involves making a decision to trade an improved breast shape and contour for some (well-placed and concealed) surgical scars on the breast. For the patient who is displeased that her nipples are downpointing, it may be a relatively easy decision. The surgical incisions are strategically placed to be as minimally noticeable as is possible. One component is around the areola, which is usually well concealed by the color difference between breast skin and areolar skin. The second component extends vertically from the '6 o'clock' position of the areola to the fold below the breast, and as the majority of this scar faces downward, it is usually quite acceptable.
Traditionally, breast lift or mastopexy surgery has involved a long, horizontal incision below the breast (in addition to the circumareolar and vertical scars), but a relatively new technique allows elimination of this incision completely.
The 'vertical scar' breast lift
For several years I have been using a 'vertical scar' technique for most breast reductions which eliminates the long, horizontal incision in the inframammary fold below the breasts. I have also adapted this technique for breast lift surgery, and have been extremely pleased with the results. As with breast reduction patients, this new technique not only eliminates the horizontal incision, but also creates more impressive breast projection and maintains it better over time. The breast lift procedure I perform not only removes breast skin but also moves some lower pole breast tissue to a higher position, increasing the projection of the nipple/areola area.
Breast lift surgery works well for patients with enough existing breast tissue to build a projecting 'breast mound'. However, in most patients it is difficult to create sustainable fullness in the upper poles of the breasts by means of a mastopexy alone. This is particularly true in patients who have experienced significant deflation following pregnancy and lactation. For patients who indicate that they wish to achieve a fair amount of fullness in the cleavage area as a result of their breast lift surgery, I recommend that they undergo augmentation mastopexy This surgery combines a breast lift with the placement of a breast implant usually of modest size, which produces the most youthful breast profile possible.

Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 123 reviews

Sagging Breasts-How to Restore and Lift Your Breasts after Pregnancy

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Thank you for your question. You are not alone as many women experience loss of breast fullness and sagging of the breast after having children.

Plastic Surgery can restore breast shape and size after pregnancy using one of three techniques:

  • Breast Augmentation with Breast Implants-If the nipple-areola is above the crease under your breast-the Inframammary Crease- then often a simple Breast Augmentation using Breast Implants can restore the breast to a full lifted appearance. Typically the implants are placed under the breast gland and not under the chest muscle.
  • Breast Lift or Dermal Mastopexy- When there is significant breast sagging and the Nipple-Areola is below the crease under your breast, a surgical Breast Lift or Dermal Mastopexy is usually required to adequately lift the breast. With the Breast Lift, visible scars around the Areola and usually on the underside of the breast are required.
  • Combination Breast Lift and Breast Implants- When the Nipple-Areola is below the crease under your breast and the breast gland has deflated a combination Breast Lift and Breast Augmentation is often required. This procedure is a common part of the "Mommy Makeover."

Be sure to consult a Board Certified Plastic Surgeon who is experienced in Breast Surgery.

Breast sagging can consist of two things: Loss of...

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Breast sagging can consist of two things:

  1. Loss of volume
  2. Downward descent of the nipple and areola

The volume loss is treated by using an implant. The downward position of the nipple requires some form of a breast lift to place it back on the front of the breast mound, well positioned above the crease below the breast.

Unfortunately, an implant does not lift the breast; it only makes it bigger. There are several kinds of lifts that can be performed depending on how much of a lift is needed to get the proper shape back in the breast.

Fixing sagging breasts with implant placement

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In my extensive experience I find that sagging breasts can be lifted WITHOUT the need for the additional scarring of conventional breast lifts. When implants are placed in front of the muscle, they will lift the breasts quite adequately; under the muscle they will not.

Howard T. Bellin, MD (retired)
Manhattan Plastic Surgeon


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If you are a suitable candidate, we can use your own breast tissue from the lower pole of your breast to provide more upper pole fullness. We have completed a 7 year study on the Naturabra internal autologous bra technique that shows that the results are long lasting and maintain the shape and projection of the breast while obviating a need for an implant. This usually involves a vertical approach which keeps the scars to a minimum as well.

Sagging of the breasts is caused by a variety of...

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Sagging of the breasts is caused by a variety of factors; such as hormones, genetics, age, and childbearing. There are no other options besides a surgical procedure to improve or prevent the sagginess of your breasts.

Women who have lost the fullness of their breasts due to age, genetics, childbirth or breastfeeding are good candidates for the breast lift procedure. If you are happy with the size of your breasts, but not the location, you may be a good candidate!

Without surgical techniques utilized in the breast lift procedure, ptosis (or sagging) of the breasts is not preventable or fixable. Of course, your favorite Miracle Bra can fix the sagging breast problem quickly if surgery is not in the horizon for you!

What are my options to correct my deflated, sagging breasts?

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#Sagging breasts can be addressed with a Breast #Augmentation, Breast Lift (#Mastopexy) or a Breast Lift with Augmentation. Often times, if the sagging is too great, it cannot be treated by implants alone.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 116 reviews

A breast lift is the perfect solution for sagging breasts

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A breast lift operation can be done alone or with an augmentation.  Alone the breast and nipple is lifted and tightened which may have developed over time or due to pregnancy and breast feeding.  Surgery is the only option to correct this.  With an augmentation, the new cohesive gel implants give a soft natural result and may even lift the breast in patients who are experiencing some ptosis or slight sagging of the breast.  Be sure to discuss which option is best for you with your surgeon.

Breast Lift with minimal scars

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Unfortunately, there is no other option other than a good bra to improve sagging breasts. Magic creams, potions or lotions do not work. However, there is a new option for breast lifting surgery that reshapes a woman's breast and anchors it securely to maximize longevity. There is no vertical scar regardless of degree of ptosis. The advantage of not having a vertical scar (other than cosmesis) is that it doesn't weaken the skin envelope. As every woman knows skin is simply not strong enough to endure the test of time and weight. So why place an incision at the point of maximum tension? It just doesn't make sense. With the Ultimate Breast Lift technique breasts are reshaped and lifted high providing upper pole fullness without breast implants. Women now have a better option for perking things up.

Kind regards,

Dr. H

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

Perking up breasts after pregnancy.

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Thank you for your question

As you've already learned, while the breasts becoming engorged during pregnancy they often become smaller than they were before pregnancy when the pregnancy is over. Volume not only diminishes but the skin can become looser as well.

It's possible that if you were to gain some weight you might restore some of the volume to the breast but you would also gain weight in other areas that might not make you so happy.  Generally gaining weight intentionally is a bad idea.

If you have just a little bit of droop then restoring volume in the form of an implant maybe your best option. For moderate droop with good volume you may benefit from a periareolar or crescent lift. For more severe droop you might need to consider a lollipop, a vertical or full mastopexy. Each of these options have different pros and cons.

A small subset of surgeons is now advocating fat grafting to the breast again.  This is controversial because as fat that is grafted absorbs in the body it can leave small calcifications that are hard to distinguish from breast cancer on mammography.  Because of this concern I do not advocate it.

A consultation with the board certified plastic surgeon would likely help you to learn what your best option is.  Best luck in achieving your goals.


Adam Tattelbaum, MD
Washington DC Plastic Surgeon
5.0 out of 5 stars 115 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.