Will going from an increase in breast volume (A to C cup) lead to sagging in the future?

Question

I am 40 and have small boobs (A cup). I am thinking of having augmentation to a C cup. I currently don’t have any sagging so I am curious - if I have bigger boobs would that lead to sagging in the future? I understand that the implant won’t sag but will the extra volume make the skin sag in the future?

Leila Kasrai, MD, FRCSC · Answer

The larger the implant, the heavier they are. As a result, they will weigh down the breasts, increasing the risk of sagging. However, it would be difficult to predict how fast the breasts would sag and to what extent.

Ted Eisenberg, DO, FACOS, FAACS · Answer

I recommend an in person consultation with a plastic surgeon to discuss your goals and be measured. After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements with different size and style breast implants, and they choose what looks right for them. They also get to see what they would look like when the breasts have fully dropped and fluffed and in clothes. You get to see actual results and the surgeon's experience and not a virtual idea of what can be achieved. Women tell me that this process is very helpful in determining what size and style breast implant is right for them. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Derek Fletcher, MD · Answer

It depends on implant and patient-related factors as well as surgeon skill. Implant size, type (textured vs. smooth) and position (sub glandular vs. sub muscular) effect the stability of breast shape. Patient skin and soft tissue integrity are critically important. High integrity, elastic skin and soft tissues can support implants well over decades. Surgeon skill and technique are also critical. 
In general, it is reasonable to assume that your implants will accelerate the natural aging changes of your breasts.

Daniel Barrett, MD · Answer

Dear A non a mouse,
breast implant type and sizing selection is a complicated process and requires a detailed consultation that includes a discussion of your goals, a detailed examination, and a lengthy discussion. But the decision will always start and end with the patient. When it comes to sizing, we have all of our patients find 3 photos of their desired breast size. We ask for naked breast photos because clothing can obscure the true size (push up bras). Next, we consult with patients and go over the photos and take detailed breast measurements during a physical exam. Next, we using a sizing algorithm to determine a range of implants that will work based on the exam and the measurements.Lastly, during the operation, we use silicone sizers in the operating room to see how the size actually looks in the breast. We sit the patient up in the operating room, while asleep of course, and compare the sizer result with their desired look photos. If it is too small, we start the process over with a slightly larger implant. We don't stop until we get the perfect match.Of all of my breast augmentation patients, every one of them has been happy with their size due to this detailed and meticulous process. You don't want to invest time and money into a result that is either too big or too small.You should discuss your concerns with a board-certified plastic surgeon and make sure that your surgeon understands your goals.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Connie Hiers, MD, FACS · Answer

If you do not go beyond a C cup and place the implants behind the muscle, you should be able to avoid sagging over time.  However, pregnancy, breast feeding, weight gain and loss, and menopause might change your breasts and cause sagging.

Sarper Mete, MD · Answer

One of the most compelling advantages of synthetic breast implants is that they hold their shape and volume over time, unlike natural breasts, which can change dramatically due to age, weight loss, breastfeeding, and other factors. However, it is critical that women considering breast implants understand that these same factors, while they don’t affect the implants themselves, can still change the overall look of their breasts over time. For example, skin laxity that occurs as a natural side effect of aging often contributes to sagging or drooping breasts. For patients with breast implants, the weight of the implants combined with a loss of skin elasticity may even exacerbate breast sagging.
The best ways to delay sagging and maintain your breast augmentation results for as long as possible include avoiding weight fluctuation, minimizing sun exposure, and waiting until you are done having children and breastfeeding before getting implants.

Camille Cash, MD · Answer

There are many factors that contribute to breast ptosis (sagging).  Some are age, genetics, pregnancy/breastfeeding, weight gain, and large breasts.  While adding implants could possibly contribute to future sagging due to the stretched skin and weight of the implant, there is no way to say for sure if it will or to what degree.

David E. Berman, MD (retired) · Answer

since your implants never sag, it is your natural skin and breast tissue that may sag with time. the size of the implants will not make this more likely. In fact probably selecting a slightly larger implant may help minimize some sagging of your breast tissue. however, for the most part, your skin and breast tissue are not affected by the implants.

david berman md, frcsc

david berman md, frcsc

Will going from an increase in breast volume (A to C cup) lead to sagging in the future?

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