Women can experience many changes to their breasts throughout their lives, one of which involves breast sagging (or breast ptosis) that may develop in one’s thirties, forties, or fifties. This very common condition can cause the breasts to lose fullness, become softer, and droop below the natural breast crease (inframammary fold). In general, there are numerous reasons that can be attributed to a loss of breast firmness:
Aging
One of the most prominent reasons for breast sagging is the inevitable aging process, wherein there are several age-related factors that can impact breast tissue, density, and volume:
- Reduced collagen production – Collagen provides structure and strength to our skin, connective tissues, muscles, bones, ligaments, and more. However, as early as our mid-to-late twenties, collagen production begins to slow down, affecting shape and support in many areas of the body, including the breasts.
- Decreased skin elasticity – Another important protein in our bodies, elastin allows the skin to contract and remain smooth and firm. But as the body ages, elastin can begin to deplete, creating laxity in the skin and breast tissue.
- Stretched ligaments – Over time, ligaments made of fibrous, flexible connective tissue in the breasts (known as Cooper’s ligaments) become weaker and begin to stretch — attributing to a loss of shape and structural support in the breasts.
Weight Changes
When tissues and skin have been stretched beyond their ability to contract back to their previous form, it can be difficult for the body to look the same as it once was. This is what can happen when there are fluctuations in weight, as the internal structures of the breasts lose support and firmness.
Hormones
Changes in hormones, particularly estrogen, can have a vital impact on the inner workings of the body. For breasts, decreased estrogen can cause the connective tissue that supports the breasts to become weaker and, therefore, sag. Two of the most common scenarios when this might occur are during:
- Pregnancy – Hormonal changes during pregnancy can often lead to weight gain. When weight is lost following childbirth, the stretched skin and tissues that contract — especially after multiple pregnancies — may be strained and contribute to sagging breast contours.
- Menopause – Decreased estrogen has been found to impair the breasts by losing fat, tissue, and mammary glands, which can also reduce the fullness and volume of breasts.
Gravity
The gravitational pull that keeps us firmly planted on the ground can also be responsible for pulling breasts downward, especially for women with larger, heavier breasts and those with macromastia (overly large breasts).
Smoking
Cigarette smoking and tobacco use can also destroy elastin and break down collagen, causing harm to two very important proteins in the body. This can lead to inelastic skin and diminished fullness and firmness in the breasts.
To help correct breasts that have lost firmness or show signs of ptosis, breast lift surgery can help to rejuvenate a more youthful-looking breast contour. This can be achieved by elevating the breasts to a higher position on the chest wall and removing any excess skin, followed by tightening the tissues and remaining skin. For a volume enhancement to accompany the procedure, a breast augmentation with lift might be recommended for a more comprehensive solution.
Dr. Neal Goldberg — a Westchester board-certified plastic surgeon — is dedicated to helping women achieve a breast shape that makes them look and feel their best at any age. To learn more about breast lift procedures and other surgeries, or to schedule a consultation with Dr. Goldberg, please contact our NYC-area office today.