There seems to be an inverse relationship between the number of birthdays celebrated and breasts: As one rises, the other falls. Here’s help if your boobs have lost their oomph.
The Problem: Sagging Breasts
The problem is multifaceted, says Dr. Steve White, the double board-certified plastic surgeon of USA Plastic Surgery in Dallas. The breast is made up of three parts, he explains: skin, fat, and breast tissue. Breasts change due to time, weight fluctuation, and hormonal variations.
“Typically, the skin changes with time by becoming thinner and losing its elasticity with aging,” he says. “The fat in the breast increases with weight gain or decreases with weight loss (particularly after sudden changes or significant amount of weight change, such as pregnancy). Finally, the breast tissue varies based on higher levels of hormones with pregnancy and lower levels of hormones with menopause.”
Women may experience a handful of these changes, which collectively result in droopy boobs, thanks to a “lax, excess skin envelope” (i.e., stretched-out skin); sagging with lack of upper-pole fullness (loss of fullness above the nipple); and breast tissue that droops below the inframammary fold (IMF), the crease under the breast, where the breast meets the chest wall.
If it sounds like breast droopage is inevitable, pretty much. “Basically, it’s unavoidable,” Dr. White says. But restoring your breasts to their former glory is not impossible — though it cannot be done with lasers or a tube of cream.
Solution #1: Wear a Better Bra
You can get an instant, if temporary, lift by wearing the right bra the right way. If you’ve become comfortable in your stretched-out, wireless number, you may be amazed to discover what a supportive (and pretty!) brassiere can do for the way you look and feel.
Solution #2: Exercise
There’s good news and bad. Chris Freytag, certified personal trainer and founder of Get Healthy U, says there is no exercise that can firm up breast tissue and restore perkiness. “However, you can build up, tone, and strengthen the pectoral muscles behind the breasts,” she says. “That will help improve the appearance of your upper body, as well as keep you strong and help with your posture.”
Freytag recommends all variations of push-ups, chest presses with dumbbells, and chest flys with dumbbells. She advocates not smoking, wearing a good moisturizer, and drinking plenty of water to stay hydrated. She also suggests wearing a good bra to keep breasts supported.
Solution #3: Surgery
Where nonsurgical fixes for sagging breasts are concerned, Dr. White has no good news. “How can you tighten loose skin without removing it or reshaping it? You can’t take a rubber band that’s been stretched and unstretch it.”
An implant may work for some women with less loose skin and a small cup size (say, an A cup). Bigger, heavier breasts that are sagging will need a lift. “What you don’t want is a rock in a sock, where you put an implant in a drooping breast,” he says.
To get an idea of the severity of your sag, consider what’s called the ptosis scale. Locate the fold under the breast (the IMF) and imagine a ruler there parallel to the floor. See where your nipple is in relation to the fold. If your nipple is at the fold, you’re at Grade 1 breast ptosis. (An implant may fill out deflation.) If the nipple is below that line, you’re at Grade 2. This and the more severe Grade 3 require a lift.
“A breast lift is designed to reposition the breast higher on the chest wall, put it back where it used to be, make the areola smaller, and remove the skin excess,” Dr. White say. “Ideally, you do it in a way that allows you to reshape the tissue and make it look like its own implant.”
Though surgery patients will have a scar, he says, most don’t have bruising, don’t need narcotics, and enjoy instant change. Some patients may benefit from (or desire) both a breast lift and implants. Take caution: Do not have these procedures at the same time, Dr. White warns.
He explains that the best fine line scars occur when you have the best blood supply, the least amount of tension, and more sutures. An implant adds weight and stretches the skin. “My preferred approach, as we’re in Texas, is doing the two-step,” he says. If you need a lift, get a lift and let it heal. If you want to go bigger, go back in for an implant.
Above all things, for all surgeries, he says, find a doctor who will tell you what you need — not just what you want.
Start your search for a board-certified plastic surgeon with the American Society of Plastic Surgeons.