I Am a Size 44g or 44h Depending on the Bra but I Am Sagging with No Real Info on How to Repair Them. HELP? (photo)

Hi I have pretty large breast I am a 44g or 44h depending on the bra. I have begun to sag horribly. I am very scared of the scars from a breast reduction and was told that my breast are to heavy for a lift. I'm now considering an augmentation but don't really want to be bigger . HELP

Doctor Answers 12


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Hi 44h,

Thanks for the photos.  Your options are limited.  You need a Breast Reduction.  As part of this procedure your breasts would be lifted.  Unfortunately, the scars are unavoidable.  The final option is to do nothing and you won't have any scars. Good luck.

Buffalo Plastic Surgeon
4.6 out of 5 stars 37 reviews

Large and sagging breasts

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From your photos, you would really benefit from a reduction mammoplasty.  This will reduce your breast size along with lifting them.  You need to decide which is worse, the scars associated with the procedure or the large, heavy, sagging breasts.  Definitely, do not put in larger implants at this stage.  This will only make you bigger and more droopy over time.

Todd C. Case, MD
Tucson Plastic Surgeon

I Am a Size 44g or 44h Depending on the Bra but I Am Sagging with No Real Info on How to Repair Them. HELP?

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    Breast reduction in most cases uses the same scar pattern as a breast lift, particularly for breasts of your size and droop.  A breast amputation technique in which the lower pole of the breast is removed and the areola is moved higher as a free nipple graft is one technique to consider.  This would save you the vertical scar, but I would not usually recommend this.  I would not recommend a breast augmentation as this will only increase the size of your breasts and will not lift them.  Kenneth Hughes, MD Los Angeles, CA

Info on How to Repair Them

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You would need to consider a breast reduction or breast lift. Either will have the same incision pattern--and "anchor" with a circle around the areola, a vertical line down to the breast fold, and a horizontal line in the breast fold. So if you are scared of the incisions for a reduction, you are also scared of the the incisions for a breast lift. 

An implant would only make you larger, and would not resolve any of the things that bother you.   

Best would be a consultation with a plastic surgeon, at which time you can look at some photos and see what the scars look like once healed. The reality may be less frightening than the imagination.

When you are ready for an in person consultation, RealSelf has listings of surgeons in your area. You should consider cross referencing the listings from the The American Society of Plastic Surgeons (plasticsurgery dot org). A listing in the ASPS website assures you that your surgeon is not only board certified,  but also is a member in good standing of the major plastic surgery organization in the U. S. Thank you for your question, best wishes.


Jourdan Gottlieb, MD
Seattle Plastic Surgeon

Best way to fix large sagging breasts

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Since your breasts are sagging and also very large, I think your best option is a breast reduction (which also lifts at the same time). This does involve the full "anchor" type of scar, but in turn provides you with a much improved shape. The photographs are taken from an odd angle, but it looks as if your nipples are at or below your elbows, and really they should be about half way between your shoulders to your elbows. I would not recommend adding breast implants. Since you are starting with a G or H cup breast, even with a reduction you could be a D or DD without implants. I prefer doing a supero-medial pedicle reduction, which tends to have better cleavage and less drooping over time, compared to some other types of reductions. I recommend seeing a board certified plastic surgeon for this type of procedure. Please see the link below for examples of before and after photos.

Anita Patel, MD, FACS
Beverly Hills Plastic Surgeon
4.7 out of 5 stars 12 reviews

Severe ptosis of the breasts require surgical correction.

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I understand the reluctance the preceding with a breast lift or breast reduction because of the scars. However, breasts is ptotic as those pictured will require formal repositioning of the areola and reshaping of the breast.

Breat Reduction Is Your Best Option

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Your photos, bra size and clinical history suggest the presence of significant symptomatic breast hypertrophy. In my experience, patients with this degree of breast enlargement derive tremendous benefit from breast reduction surgery. In fact, many patients consider it a life changing experience. Under these circumstances, breast implants would offer no advantage. Consultation with a board certified plastic surgeon would be a helpful next step.

It's a tradeoff

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If your goal is to be less saggy and to have smaller breast, then a breast reduction would be the best surgical option.

Breast reduction.

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talk to people who have had breast reductions.  they are generally very happy and so glad they did it.  NO AUGMENTATION

Jonathan Saunders, MD
Newark Plastic Surgeon

I Am a Size 44g or 44h Depending on the Bra but I Am Sagging with No Real Info on How to Repair Them. HELP?

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Thanks for the question and posted photos. Best to lose some weight. Than consider a breast reduction surgery. 

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.