What caused my breasts to sag like this?

If you’ve noticed your breasts have been drooping more than they used to…

April 28, 2021

5 min read

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…you’re probably wondering what happened to cause that and what you can do to change it.

Brief Anatomy of the Breast

To understand what’s caused your breasts to change, it’s important to first understand the basic anatomy of your breasts.

Skin

All of the skin on your body has collagen.  Collagen is important in providing elasticity to your skin so that it can stretch and move with your body. That elasticity can be lost over time, because your skin gets too stretched out or as one of the normal processes of aging.1

On your breasts, you have two visible structures – the nipple and the areola, which can be called the nipple-areolar complex if you’re talking about them together. These are typically darker than the rest of your skin and the size of these structures varies from person to person. If you’re lactating, milk is secreted at the nipple, and your areola secretes fluid to keep your nipple lubricated during breastfeeding.

Beneath the Skin

There’s a whole lot going on underneath the visible surface of your breasts. Connective tissue, glands, ducts, and fat that all contribute to the shape and perkiness of your breasts.

Connective tissue

There are special ligaments in your breasts, called “Cooper’s ligaments”. These are responsible for supporting the internal structures of your breasts2.  In a nutshell, they determine how lifted and perky your breasts are.

Mammary Glands and Ducts

During puberty, the breasts grow and there are undeveloped lobes within them.  These lobes become fully developed when you become pregnant. Hormones signal your breasts to begin producing milk, causing your lobes fully develop and fill. The milk travels from the lobes through special ducts, and out of your nipples into the mouth of your baby.3

Fat

Fat gives your breasts their shape and fullness. Typically, a full-looking breast has more fat in it.

Muscle

Your breasts sit above your main chest muscle, called the “pectoralis major”. This muscle doesn’t determine breast shape.  In cases of a very well-developed pectoralis, it may push out the chest very slightly. For all intents and purposes, the muscle is a very minor contributor to how your breasts look.

What causes sagging?

Now that we know a little bit about the anatomy of your breasts, it’ll be easier to understand how that anatomy is affected over time and how that leads to sagging.

Skin

We know that skin has elasticity, but that elasticity is lost over time due to aging or from being stretched too far. The skin of your breasts is like a balloon that holds your internal breast structures. If this internal structure grows too much for the skin to accommodate it, your skin can lose its elasticity and become droopy and saggy. So you could have a little bit of loose skin and droopy nipples, or your whole breast might sag.

Cooper’s ligaments

Since these ligaments are made to support your breast tissues, they’re constantly working against the forces of gravity. Unfortunately, eventually they can weaken and also lose their elasticity over time, which contributes to breast sagging.

Factors that can increase sag

Pregnancy

The hormonal changes that come along with pregnancy cause your breasts to become fuller and heavier, which puts extra strain on the Cooper’s ligaments and stretches out your skin4. After childbirth, your hormone levels return to normal, but your breast size and shape are already altered. Usually, a higher number of pregnancies results in saggier breasts.5

Some women are concerned that breastfeeding is what causes their breast sagging after childbirth, but some studies have shown that it may not be the breastfeeding that causes your breast to sag. The sagging may have already been caused by the pregnancy itself and its related hormones.6

Weight gain and weight loss

Gaining significant amounts of weight can cause you to store more fat in your breasts, which makes them heavier and puts more strain on the Cooper’s ligaments. This also stretches out your skin. Even if you lose that weight, the skin and ligaments are already stretched and weakened, and you’ll have sagging.7

Aging

Unfortunately, time and the constant battle against gravity wears down the elasticity of your skin and ligaments too. Women with large breasts will likely notice sagging sooner, and wearing a bra that doesn’t support well can also contribute to the problem.8

Smoking

Smoking has been shown to cause your skin to lose its elasticity more quickly than it would over the course of your normal aging.

Genetics

Some women are genetically predisposed to having saggier breasts.

What can I do about it?

You may have been thinking for a while about improving the appearance of your sagging breasts. There are a lot of things out there that claim to help, but be careful what you pay for – you may not get your money’s worth.  

Non-surgical options just don’t work

If you’re researching non-surgical options to lift your breasts, you’ve probably seen a few that seem promising. There have been claims that ultrasound, radio waves, or even laser can give you a satisfying lift. There are also injections and creams that claim to correct sagging. Unfortunately, the most you’ll see with these methods is a little surface skin tightening at best, which can’t give you the lift that you’re looking for.

What will work?

The method that has been shown to actually work to lift your breasts is a surgical procedure called a “mastopexy”.

Mastopexy

Mastopexy is also called “breast lift” surgery, and its purpose is to restore your breast to its pre-sagging position on your chest. It involves the removal of extra skin, and the raising of your nipple9. Don’t worry, in most cases, your nipple is not removed! It stays attached to your breast, but the surrounding tissue is removed to lift and reshape your breast. This leaves your nipple in a higher, more attractive position. For more information on mastopexy and its variations, click here.

It’s important to remember that a mastopexy alone won’t change your breast size, since it involves the removal of superficial tissue. Mastopexy is for reshaping and lifting. But if you’re interested in changing the size of your breasts, there are options, too. To make your breasts bigger and lift, click here to read about our simultaneous augmentation and breast lift. To make your breasts smaller and lifted, click here to visit our page on breast reduction 

Schedule today!

If you’re concerned about your breasts drooping and sagging, schedule an appointment with a plastic surgeon. They can assess the shape and position of your breasts, and help you decide if a mastopexy is right for you.

  1. Aziz, Jazli, Hafiz Shezali, Zamri Radzi, Noor Azlin Yahya, Noor Hayaty Abu Kassim, Jan Czernuszka, and Mohammad Tariqur Rahman. “Molecular mechanisms of stress-responsive changes in collagen and elastin networks in skin.” Skin pharmacology and physiology 29, no. 4 (2016): 190-203.
  2. Jesinger, Robert A. “Breast anatomy for the interventionalist.” Techniques in vascular and interventional radiology 17, no. 1 (2014): 3-9.
  3. Jesinger, Robert A. “Breast anatomy for the interventionalist.” Techniques in vascular and interventional radiology 17, no. 1 (2014): 3-9.
  4. Jesinger, Robert A. “Breast anatomy for the interventionalist.” Techniques in vascular and interventional radiology 17, no. 1 (2014): 3-9.
  5. Soltanian, Hooman T., Mengyuan T. Liu, Adam D. Cash, and Rodrigo A. Iglesias. “Determinants of breast appearance and aging in identical twins.” Aesthetic surgery journal 32, no. 7 (2012): 846-860.
  6. Rinker, Brian, Melissa Veneracion, and Catherine P. Walsh. “The effect of breastfeeding on breast aesthetics.” Aesthetic Surgery Journal 28, no. 5 (2008): 534-537.
  7. Soltanian, Hooman T., Mengyuan T. Liu, Adam D. Cash, and Rodrigo A. Iglesias. “Determinants of breast appearance and aging in identical twins.” Aesthetic surgery journal 32, no. 7 (2012): 846-860.
  8. Fisher, Gary J., Sewon Kang, James Varani, Zsuzsanna Bata-Csorgo, Yinsheng Wan, Subhash Datta, and John J. Voorhees. “Mechanisms of photoaging and chronological skin aging.” Archives of dermatology 138, no. 11 (2002): 1462-1470.
  9. Hidalgo, David A., and Jason A. Spector. “Mastopexy.” Plastic and reconstructive surgery 132, no. 4 (2013): 642e-656e.

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