Sagging Breasts — What Can Be Done?

Depending on the degree of breast ptosis, several breast lift techniques are available. At the VIRTUS Institute, patients can address multiple concerns during a single procedure and achieve the beautiful breasts they have always dreamed of.

What Is Breast Sagging (Breast Ptosis)?

Breast ptosis is the medical term for the sagging of the breasts. The breasts take on a teardrop shape, lose volume and firmness, and the nipples shift downward. This happens because the breasts contain no muscles—their shape is supported by the skin and Cooper’s ligaments. Over time, under the influence of various factors, this supporting framework stretches, causing the breasts to sag.

Why Do Breasts Sag?

Breast sagging is a natural process influenced, among other things, by age-related changes that reduce the production of collagen and elastin. As a result, Cooper’s ligaments and the skin stretch and can no longer maintain the breast shape. In younger women, breast ptosis may develop due to rapid weight loss, pregnancy, and breastfeeding.

Sagging Breasts After Childbirth

During pregnancy, hormonal changes cause the mammary glands to enlarge. After childbirth, hormone levels gradually return to their previous state, so the breast tissue decreases in volume again, while the skin has already stretched. As a result, the breasts sag due to excess skin and loss of volume.

Sagging Breasts After Breastfeeding

As the body prepares for lactation, the breasts fill with milk, increasing their weight. The supporting ligaments and skin are unable to cope with the additional load. There are also other contributing factors: if the baby frequently pulls on the nipples, they may stretch and even become injured. In addition, breastfeeding in the same position repeatedly may lead to uneven stress on the breasts and reduced breast firmness. All of these factors directly contribute to breast sagging after breastfeeding.

Sagging Breasts After Weight Loss

The breast contains a certain amount of fatty tissue. During weight loss, this fatty tissue decreases, reducing breast volume while the skin remains stretched. As a result, the breasts sag after losing weight.

How Is the Degree of Breast Ptosis Determined?

Normally, the nipple-areola complex is located above the inframammary fold (the natural fold beneath the breast where the underwire of a bra rests). In cases of breast ptosis, their relative position changes. Accordingly, three degrees of breast sagging are distinguished:

• Grade I: the nipple-areola complex is at the level of the inframammary fold;
• Grade II: the nipple-areola complex is below the inframammary fold but still faces forward;
• Grade III: the nipple-areola complex is below the inframammary fold and points downward.

The skin’s ability to contract naturally and improve breast shape depends on skin quality and age. Theoretically, younger women may have a chance to improve breast shape without surgery.

Can Sagging Breasts Be Lifted Without Surgery?

Unfortunately, non-surgical methods of correcting sagging breasts have very limited effectiveness. Physical exercise can strengthen the pectoral muscles, but it cannot remove excess skin or restore the position of the mammary glands. It is also impossible to increase breast volume through exercise because the breasts consist of glandular and fatty tissue rather than muscle. Massage and supportive shapewear are also of limited benefit.

What Methods Help Correct Sagging Breasts?

The most effective way to restore breast shape is surgical breast lift (mastopexy). To determine which procedure will provide the best possible result, you should schedule a consultation with a plastic surgeon at the VIRTUS Institute. This can be done after breastfeeding has ended, once prolactin and other hormone levels have returned to normal. If prolactin levels remain elevated six months after breastfeeding has stopped, the doctor may prescribe medication to lower them.

When Is a Breast Lift Necessary?

A breast lift is recommended when a woman experiences physical or emotional discomfort due to sagging breasts. For Grade I ptosis, breast lift surgery alone usually provides excellent results. If additional volume is required, periareolar mastopexy may be combined with bio-implantation (using the patient’s own fat tissue) or breast implants.

How Should You Prepare for Breast Lift Surgery?

Before surgery, all necessary laboratory tests should be completed, including hormone testing and a breast ultrasound examination. If the patient smokes, it is advisable to quit during the surgery and recovery period to promote better scar healing.

The procedure is usually scheduled 6–12 months after breastfeeding has ended, depending on prolactin levels. If a woman has given birth but did not breastfeed, breast surgery can generally be performed one year after childbirth.

How Is Breast Lift Surgery Performed?

Breast lift surgery takes from 40 minutes to three hours, depending on the extent of the procedure. The following breast lift techniques are used:

• Periareolar mastopexy — the incision is made around the areola.
• Vertical mastopexy — incisions are made around the areola and extend vertically downward.
• T-shaped (anchor) mastopexy — incisions are made around the areola, vertically downward, and along the inframammary fold.

The extent of the procedure depends on the degree of breast ptosis and is determined during the consultation with the plastic surgeon.

A breast lift may be combined with breast implant placement or fat grafting (bio-implantation). In addition, if the duration of surgery allows, abdominoplasty (tummy tuck) can be performed simultaneously, allowing two concerns to be addressed during a single operation.

What Results Can Be Expected After a Breast Lift?

The first results of breast lift surgery can be seen as early as the first postoperative dressing change: the breasts are lifted and positioned where they should naturally be. However, the final outcome can be fully evaluated approximately six months after surgery, once the scars have completely healed.

Recovery After a Breast Lift

After breast lift surgery, the patient usually stays in the hospital for one to two days. During this period, she receives medications to reduce swelling, as well as anti-inflammatory drugs and pain relievers.

The patient wears a special compression garment, which should be worn for one month. A full shower is usually permitted 7–9 days after surgery, although the areas of the body that were not operated on may be washed immediately.

During the first month after surgery, the patient should visit the surgeon at least three times for follow-up examinations and dressing changes.

The plastic surgeon will also recommend:

• avoiding direct sun exposure;
• avoiding swimming in the sea;
• if the breast lift was combined with breast implantation, not raising the arms above shoulder level for two weeks;
• limiting sports and other physical activities for one month.

In most cases, if healing progresses normally, the patient can return to her usual daily routine the following month.

Can Breast Sagging Be Prevented?

Since breast ptosis is a natural process associated with age-related hormonal changes, preventive measures can only provide limited results. However, to help reduce breast sagging, it is recommended to:

• avoid sudden weight fluctuations;
• wear a properly fitting bra regularly;
• exercise consistently;
• take proper care of the skin.

These measures cannot guarantee that the breasts will never sag, but they can help maintain skin elasticity and breast support for as long as possible.