About Mammoplasty

Why do Breasts Sag? How to Lift Saggy Breast?

A “saggy breast” or “breast ptosis” is mentioned in cases where the nipple is at or below the level of the “inframammary fold”, which is the junction line of the anterior chest wall with the lower breast tissue.

In an ideal breast, the skin surrounding the breast is tight and elastic. When not loose, the ligaments firmly keep the breast tissue connected to the anterior chest wall.

When the breast skin loosens due to any factor, the suspensory ligaments of the breast tissue loosen and lengthen, and gravity causes the breast mass and nipple to moved downwards, resulting in breast sagging.

Causes of Breast Ptosis

The causes identified in a study conducted on 132 patients who presented with the complaint of breast ptosis are as follows;

  • Age (ptosis increases with advancing age)
  • Significant weight loss (more than 22.6 kg)
  • Higher body mass index (being overweight or obese)
  • A large breast volume, that is, a large bra cup size
  • Number of pregnancies (as the number of pregnancies increases, the ptosis also increases)
  • Smoking history

The same study found no significant relationship between breast ptosis and factors such as breastfeeding, weight gained during pregnancy, and not doing exercises intended for the chest area. (References 1)

In another study that enrolled 125 patients who presented with the complaint of breast, breast tissue weight was found to be the most important factor of breast ptosis, which causes the breast to sag with the effect of gravity if the breast tissue is larger than normal. In the same study, smoking was reported to be an unimportant factor. (References 2)

A special group of patients who have sagging breasts and need breast lift procedure are those who have previously had breast augmentation surgery with silicone implants. Due to the weight of the silicone implant and the loosening of the breast skin and tissues over the years cause sagging of the breasts.

The larger the silicone implant, the heavier it is and the more sagging it causes. In such a case, a breast lift operation is performed by removing the excess skin and breast tissue three-dimensionally. The silicone implants are also replaced with new ones during the same procedure. In the meantime, the size and shape of the silicone implants can be changed if desired.

Main Causes of Breast Sagging

According to the American Society of Plastic Surgery, the most important factors that play a role in breast sagging include;

  • Pregnancy
  • Breastfeeding
  • Weight fluctuations
  • Aging
  • Gravity
  • Heredity (References 3)

How to Lift Saggy Breast?

Plastic, Reconstructive and Aesthetic Surgeons perform “mastopexy” (breast lift) to restore sagging breasts to their normal form.

In the preoperative examination, the degree of breast sagging is identified and the appropriate surgical procedure is selected accordingly. Choosing the appropriate procedure and performing it properly require a great deal of knowledge. The operation leaves scars to some extent that may vary depending on the surgical technique used. The scars usually become unnoticeable within 6 to 24 months.

With the breast lift procedure, the nipple, which has descended below the inframammary fold, is raised to the required level. If the brown are (areola) around the nipple is enlarged, its diameter is reduced.

In addition, excess loosened and enlarged breast skin is removed three-dimensionally, and the breast is given its ideal shape. In addition, the breast tissue and skin are reshaped to give the breast the desired form. This surgical procedure does not change the volume of the breast tissue, that is, the bra cup size.

If it is desired to increase the volume, and especially to make the cleavage areas of the breast fuller, in addition to the elimination of the sagging breast problem, breast augmentation with a silicone implant is performed in conjunction with breast lift.

On the other hand, breast reduction surgery is performed in cases where a sagging breast is also larger than normal in mass. Breast reduction surgery that reduces breast volume and bra cup size by removing excess breast tissue also involves a lifting procedure.

There are some procedures, such as thread lift, which are claimed to lift sagging breasts without surgery, but I personally believe that these procedures are not effective enough and their effects are temporary or at least short-lived.

You can find more information about breast lift on the breast lift page of my website.


  1. https://pubmed.ncbi.nlm.nih.gov/20354434/
  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5147386/
  3. https://www.plasticsurgery.org/cosmetic-procedures/breast-lift

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