Is skin tightening laser the best treatment for breast sagging?

Lasers do not tighten skin significantly if at all. Modest ptosis can be treated with a small breast augmentation. More significant ptosis might require a mastopexy.

A 'skin tightening laser' will do absolutely nothing for your breast skin - except possibly burn it or create pigmentation changes. Talk to a board certified plastic surgeon about a breast lift procedure to improve breast shape and skin appearance. 

This is a very common scenario for women who have had children or have experienced significant weight loss. Our ability to consistently improve the tone of the breast skin with the current choice of non-surgical treatments is very limited. For early age related changes and mild skin laxity there may be some newer energy devices (laser, light and radiofrequency) that can be considered. The best results with these devices occur in younger, thicker skin and require multiple treatments. It is ideal that you get an opinion from an Plastic Surgeon who has experience with surgical and non-surgical options. Before any breast skin treatments it is essential to have a healthy breast examination and to discuss risks associated with recommended treatments.

Loose breast skin is best treated by a breast lift procedure where the excess skin is removed. Lasers are commonly used for modest facial skin tightening and would not be effective on the breasts. Please schedule a consultation with an experienced plastic surgeon who is certified by The American Board of Plastic Surgery to learn about how to rejuvenate your breasts.

Thank you for the question. Based on your description of your breasts, it is most likely that you will benefit from breast lifting plus/minus breast augmentation surgery. Lasers are not effective. You may wish to attach frontal and side view pictures of your breast ( along with goal photographs) with your next question form more precise advice.
You will do best by seeking consultation with well experienced board certified plastic surgeons. Ask to see lots of examples of their work and communicate your goals clearly. Patients who are considering breast augmentation/lifting surgery should understand that this combination surgery is significantly more complex than either one of the procedures done separately.  In other words, the combination breast augmentation / mastopexy surgery differs from breast augmentation surgery alone in that it carries increased risk compared to either breast augmentation or mastopexy surgery performed separately.
Furthermore, the potential need for revisionary surgery is increased with breast augmentation / mastopexy surgery done at the same time. This revisionary rate may be as high (or higher) than 20%.  
Personally, I find that the breast augmentation/lifting procedure to be one of the most challenging of the breast operations I perform, even compared to somewhat complex revisionary breast surgery. On the one hand, when performing breast augmentation/lifting surgery we are increasing the breast size with breast implants; on the other hand, we are reducing the breast “envelope” in order to achieve the breast lift. These two “forces” must be balanced as perfectly as possible in order to achieve the desired results. Removing too much skin/ breast tissue is problematic; removing too little breast skin/tissue can also be problematic. Remember also that patients presenting for breast lifting surgery and general have lost some skin elasticity/thickness making potential incision line healing problems and/or recurrent drooping/sagging important concerns to communicate.
The analogy I use in my practice is that of a thinned out balloon, being expanded with additional air, while at the same time removing some of the balloons rubber surface. I hope that this analogy helps patients understand some of the issues at hand when performing the combination breast augmentation/lifing operation.
To achieve a surgical result where the breast implant and breast tissue “come together” and behave like a single breast is one of my goals but can be difficult to achieve. Essentially, we are trying to create a breast implant/breast tissue interface that feels and behaves as naturally ( as a single unit) as possible. Generally speaking, making sure that the breast implant has some sub muscular and some sub glandular component ( dual plane) and tailoring the overlying skin/subcutaneous tissue/breast tissue as precisely as possible over the underlying breast implant is key.
Despite these efforts, breast implants are after all a foreign body that don't necessarily stay where we wish they would; therefore, breast implant related problems such as positioning ( too high, too low, lateral displacement etc.) can occur and may be a reason for returning to the operating room for revisionary breast surgery.I use a “tailor tacking” technique that allows a determination of what breast implant should be used to SAFELY produce the results the patient is looking for. This technique involves use of a temporary sizer and temporary “closure” of the overlying breast skin over the sizer. The use of the tailor tacking technique is very helpful. Breast lifting involves removal of skin ( and tightening of the breast skin envelope) while breast augmentation involves expansion of the breast skin envelope. These 2 forces are counteracting each other. Again, despite these efforts, breast implant and/or tissue/skin complications may arise causing minor or significant complications.
Generally speaking, it is difficult to achieve the “perfect” result with breast augmentation/lifting surgery, despite best efforts. Patients should be aware of the complexity of this combination procedure, achieve REALISTIC EXPECTATIONS prior to proceeding, and understand that additional surgery ( along with the additional recovery time, stress, expenses etc) may be necessary in the short or long-term. Patients should understand that the results of the procedure will not necessarily match aesthetically the results of patients who have undergone breast augmentation surgery only.
For example, some patients who wish to maintain long-term superior pole volume/"roundness" may find that this result is not achieved after the initial breast augmentation/lifting operation. An additional operation, possibly involving capsulorrhaphy, may be necessary to achieve the patient's longer-term goals ( with superior pole volume/roundness). It is helpful if patients understand that this breast implant capsule used to provide the support for the breast implant is not present during the initial breast augmentation/lifting operation. The capsule (layer of scar tissue) forms around the breast implant and may be a good source of supportive tissue during revisionary breast surgery, Including correction of breast implant displacement/malposition problems ( such as bottoming out, symmastia, lateral displacement etc).
Potential risks associated with breast augmentation/lifting surgery include infection, bleeding, incision line healing problems, loss/change of nipple/areola complex sensation, and blood flow related issues to causing skin or tissue necrosis. Poor scarring, pigment changes, areola/nipple asymmetry etc. are also potential problems. Again, patients may experience implant related problems such as encapsulation, leakage, displacement problems ( too high, bottoming out, lateral displacement, asymmetric positioning etc.), rippling/palpability of breast implants etc. Patients may also be dissatisfied with breast size, shape, and/or how the breast implants and overlying breast tissues “interface” with one another. Occasionally, a breast implant may even have to be removed and the patient will generally be “implant free” for several months at least. Obviously, this situation can be quite physically, emotionally, and psychosocially stressful to the patient involved.
Given the complexity of the combination breast augmentation/lifting operation and the greater risk of revisionary breast surgery needed, there are good plastic surgeons who will insist on doing the procedures separately. For me, if I see a patient who needs a great degree of lifting, who has lost a lot of skin elasticity, or whose goal is a very large augmentation then I think it is best to do the procedures in 2 stages (in order to avoid serious complications). However, doing the procedure in one stage does increase the risks of complications in general and the potential need for further surgery. This increased risk must be weighed against the practical benefits of a single stage procedure (which most patients would prefer).
Conversely, if I see a patient who requires minimal to moderate lifting along with a small to moderate size augmentation (and has good skin quality), then doing the procedure one stage is much safer. Nevertheless, the potential risks are greater with a 1 stage procedure and the patient does have a higher likelihood of needing revisionary surgery.
Having discussed some of the downsides and potential risks/complications associated with breast augmentation/lifting surgery, most patients (If properly selected and who are doing the operations at the right time of their lives psychosocially) accept the scars associated with breast augmentation/breast lifting surgery as long as they are happy with the improvement in contour, size, and symmetry. I hope that this summary of SOME of the issues surrounding breast augmentation/lifting surgery is helpful to you and other women considering this procedure in the future. The attached link may also be helpful. Best wishes.

Unfortunately the only way to effectively tighten the breast requires an incision and removal of skin at this point in time.  Even non surgical treatments such as Ulthera and Thermage will only have limited effect.  Maybe by the time you finish having your family, there will be other options.  For the moment, surgery is the only viable option to see significant results.  Best of luck

All Plastic Surgeons wish that we could completely reverse the changes that happen to the body and tissues with child bearing and living long enough to develop these problems. The difficult fact is that child bearing takes a toll on breast tissue and much of this change is irreversible. The tissue is never as firm and there can be variable amounts of extra skin and sagginess, depending on the persons genetics. I hate to be a downer, but this must be said to answer the question honestly. The field of Plastic Surgery has long been looking for a non-invasive way to shrink skin to the degree that would significantly reverse the effects of age and childbearing on the breast. Many newer technologies may claim that they can do this, but more often than not these expectations just set the patient up for disappointment and the loss of the money. Be careful and adjust your expectations when dealing with laser or other non-invasive technologies for skin tightening. Unfortunately at the present time, the correction of significant breast sagginess requires you making a compromise in accepting the unpleasant and many times unacceptable scars associated with a formal breast lift procedure.

I don't know of any laser that can fix a saggy breast the way a breast lift can.  If there were such a laser, believe me, I would buy one!You should look into having a breast lift.  If you are planning on having more children, the lift can usually be done in such a way that would not interfere with future breast feeding and if you sagged again - the lift could be repeated.I usually recommend that women wait until they are done with babies before having a lift but occasionally a patient is really, really miserable with their sagging and risking the need for another lift after another baby may be reasonable.  

Unfortunately, the state of the art in tightening skin with nonsurgical treatments is still in its infancy and of absolutely no value for breast skin. Don't get talked into this as it will be a complete and total waste of your money.