There are many things to consider regarding breast lifting (or mastopexy) procedures in teenage patients. Females typically reach skeletal maturity by their first menstrual period (menarche). Most breast development occurs in the first couple of years after that. It is not uncommon for breast development to occur unevenly. This size difference should equal out by the late teenage years. A physican should monitor uneven breast development and make sure that no breast mass is present. Mammary glands continue to develop in the early 20's, often creating a somewhat fuller and rounder breast. At age 35, breasts often start an involutional phase and atrophy. Prior lactation and weight loss can lead to further atrophy and ptosis (droop).Patients with juvenile hypertrophy of the breasts can present with very large breasts that abnormally continue to keep on growing. Typically these patients present with both large and saggy (ptotic) breasts. They frequently need breast reduction surgery to alleviate back pain, fold rashes, and bra strap grooving. Sometimes, breast growth continues and a revision breast reduction is necessary. Most patients present with more common breast deformities such as macromastia (large breasts), ptosis (drooping breasts), or tuberous breasts (constricted lower pole of the breast). At 15, breast development is expected to change. Surgery can affect nipple sensation and the future ability to breast feed. Patients who undergo surgery in their mid teens will more frequently need revisional surgery in their lifetime.All of this being considered, teenage patients with significant breast issues can sometimes benefit both physically and psychologically from elective breast surgery. Of course, teenage patients and their parents should see and discuss any potential surgical options with a board certified plastic surgeon.