Why Do Breasts Sag with Age?

Just as the skin on the face becomes thinner and weaker with age, so does the skin everywhere on the body. Without the continual renewal of strong collagen, the skin loses firmness and elasticity. This diminishes its ability to withstand the force of gravity. On the face, this may look like downturned corners of the mouth. On the body, it may look like sagging breasts. In the context of the breasts, too, we have to consider how the weight of breast tissue contributes to this aging process. Then, if a woman has had children has breastfed, or has lost a significant amount of weight, her breasts may have morphed from high-sitting, perky mounds to flattened, droopy bits of tissue.  Normal? Yes. Also, quite frustrating.

How a Breast Lift Makes You Look Younger

The breast lift procedure is designed not to add volume to the breasts via implants but to sculpt the breast mounds to make the most of existing natural tissue. To change the appearance of the breasts, the surgeon removes skin using precise incisions. Depending on the degree of laxity and its effects on the areola and nipple, multiple incisions may be made. This can allow the surgeon to change the position, projection, and overall shape of the breasts and also reduce the size of the areola to further rejuvenate appearance. Breasts that sit higher on the chest wall and project more directly forward, that have small, forward-pointing nipples, look younger. For further enhancement, some women combine their lift with slight breast augmentation to fill out more of the breast mound after deflation due to breastfeeding and aging.

How to Tell If You Might Benefit from a Breast Lift

It can be difficult to know if or when you may benefit from a breast lift because the changes that affect appearance occur so gradually. These changes don’t happen from one pregnancy, or even from multiple. Women we meet often express that they became increasingly concerned about the appearance of their breasts over time. If you’re noticing the following changes, you may be a good candidate for a breast lift:

• The nipples fall below the natural crease beneath the breasts. Some surgeons recommend doing what is called a pencil test. Really, any long item, a pen or straw even, can be placed in the crease under the breast. With the item in place, observe your reflection in a mirror and evaluate where your nipple rests in relation to the item.
• The nipples point downward rather than forward.
• The breasts look longer or flatter.
• The breasts are no longer firm.
• The areolas are enlarged.
• The breasts have stretch marks.

Learn More

You don’t have to have a specific number of the mentioned concerns to be a good candidate for a breast lift. You are the expert of your own body. If your breasts have changed significantly over time and you want them to look perkier, come and talk to us. Contact our Austin office at (512) 450-1077 to schedule a consultation with Dr. Trussler.

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Stabilize

We tend to talk a lot about reaching a sustainable weight before undergoing body-contouring procedures like liposuction and we should encourage the same for women considering breast lift surgery. Weight changes equal breast changes. Because of this, an increase in weight after breast lift surgery could degrade results by first making breast tissue heavier and then, when weight is lost, by deflating breasts of volume. Stabilizing weight can, therefore, be one of the best ways to maintain perkier breasts.

Supplement

One may not make an immediate connection between nutrition and the results of breast lift surgery. Stick with us here. Part of the reason why breasts sag is because connective tissue and skin degrade over time. We attribute this to aging and that is true to an extent. The main issue is that the body doesn’t produce enough collagen to keep the skin and connective tissue firm. This is where supplements come in. Vitamin C, in particular, is integral in the body’s collagen-production capacity. Experts recommend taking 500 to 1,000 milligrams of time-released vitamin C daily to support aging skin.

Support

Breast tissue does need support, but not too much. A mistake that some women make is taking all of the work from their chest muscles and tissue and placing it onto a pushup bra. By eliminating the need for muscles to support the breasts at all, atrophy occurs and exacerbates the natural sag that occurs over time. The best bras are those that apply very gentle pressure that holds breasts in their natural position without immobilizing them.

Breast lift surgery can be one of the best things a woman does for herself. If you’re interested in restoring shape and projection to your breasts without the use of implants, contact our office to schedule a consultation with Dr. Trussler.

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Common Structural Complaints

There are a few common complaints that occur as a woman’s body ages. While each may be slightly nuanced, the underlying cause of each comes down to the degradation of the envelope of skin and superficial muscle that supports breast tissue. Some of the improvements that can be achieved with breast lift surgery include:

• Most younger women could get by with minimal support from a bra if any at all because the envelope of tissue across the chest wall holds breasts at a nice height. This means that breasts project in a way that makes them appear firm and perky.
• Breast lift surgery is not about increasing volume, necessarily, but about reinstating the voluptuous nature of a woman’s breasts through refinement. Dr. Trussler may perform mastopexy with auto-augmentation, a procedure that redistributes the fatty tissue of the breast to add contouring where needed. Even a traditional breast lift enhances shape simply by restoring the proper cradle support around breast tissue.
• Nipple direction. The average woman may know that her breasts will droop at some point. Rarely do the nipples come to mind, though. There is an inherent expectation that nipples will point forward, always. Not so. Breast sagging can take the nipples downward. Mastopexy may involve the slight alteration of the areolae and surrounding skin to redirect the nipples in a forward projection.

Women in the Austin, TX area need not look far to find an experienced cosmetic surgeon who can help them refine their shape. Learn more about breast lift procedures at (512) 450-1077.

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Determining Whether a Breast Lift is Needed

Often, women who do not have breast tissue sitting on her abdomen, and where the nipple and areola (the tissue surrounding the nipple) are not the lowest parts of her breasts, will typically not need a breast lift.

Many women whose breasts droop somewhat, or whose nipples and areola are the lowest parts of her breasts, may need a breast lift to achieve their desired results.

However, if a woman’s breasts droop excessively and the upper parts of her breasts appear deflated, she is a good candidate for a breast lift. Augmentation or implants alone will not be enough to correct the drooping, and often times will only make the problem worse.

Why Aren’t Implants Enough?

A surgeon augments a woman’s breasts by placing implants under her chest muscles. However, instead of making the breasts perkier, women would simply have larger breasts that continue to be droopy. Also, placing an implant to fill out excess skin would only speed up the stretching process, worsening the appearance of the breasts. A breast lift will tighten the skin and reshape the breasts. Especially for post-pregnancy mothers, a breast lift will help restore the volume to their breasts that they once had.

Considering a Breast Lift? Dr. Andrew Trussler Can Help You.

Dr. Andrew Trussler, a plastic surgeon in Austin, Texas, has extensive experience in the field of cosmetic surgery, including breast lifts and augmentation. If you are interested in having a breast lift in Austin and would like more information, then please contact our Austin office. We can be reached at (512) 450-1077. We look forward to hearing from you.

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Breast asymmetry is normal in the majority, if not all women. In the women who present for breast enhancement, breast asymmetry should be identified pre-operatively and discussed, but in most cases no correction is warranted.

• Breast asymmetry does move along a continuum of mild, moderate and severe, and it may vary in size and shape of the breast.

In patients where there is a mild, but noticeable size discrepancy and a breast implant is planned, this discrepancy can be compensated and corrected with different volumes of breast implants. Mild discrepancy in shape can also be corrected with breast implants, but slight nipple re-positioning may be added to level any nipple areolar differences.

Moderate breast asymmetry, is usually related to both breast volume (size) and the amount of sagging or ptosis on one side (shape). In these cases, different volumes of implants may be needed, but more commonly a more aggressive breast lift on one side with matching implants can usually correct size and shape differences. In these cases, it is important to have relatively matching scars, even if a breast lift is not needed on one side. This is usually a periareolar scar to match the other side’s breast lift (mastopexy) scar.

Severe cases of breast asymmetry, may be indicative of a congenital breast deformity with constriction of one breast and normal development of the other side. This can lead to difficulty fitting into bras, negative self-image, and social embarrassment as the young woman matures.

In these, severe cases a two staged or two surgery approach is often beneficial for an effective and long-lasting result.

• The first stage would include a breast reduction or a breast lift on the larger side, because typically there is breast sagging on that side, and then a tissue expander or expandable breast implant on the constricted side. This enables the expansion of the breast tissue gradually as the tissue expander is filled slowly with saline at regular intervals to help create a pocket for a permanent breast implant which would match the other side. a remote port is used for this tissue expander so that the central and sensate breast does not need to be poked with needles. A side chest port is easy to locate and reliable for gradual filling of the expander.
• The second stage after breast expansion is complete (usually 6 months), is the removal of the tissue expander and replacement with a permanent breast implant with a possible periareolar mastopexy if there is herniation or enlargement of the areola. A breast implant may be placed under the previously lifted breast on the other side. An auto-augmentation can sometimes negate the need for an implant on this non-constricted side.

Drains are often used when changing a tissue expander to a breast implant. These are typically removed in one week. Recovery is likened to any breast procedure:

• outpatient operation lasting 1 to 3 hours
• mild discomfort for 1 to 3 days,
• back to school or work in less than one week,
• cardio activity in 3 weeks and heavy lifting in 4 to 6,
• scar care starting at 3 weeks.

Fat injections are not reliable enough to precisely correct volume differences, but may be used is areas of breast pocket thinness after expansion and implant placement.

Correcting breast asymmetry is not always needed, but in noticeable and severe cases, correction can greatly benefit the patient physically and psychologically. These are complex reconstructive and cosmetic cases which may take over a year to complete the entire process. With this approach long-lasting results can be achieved and effective correction of the asymmetry can be expected.

The first step in correcting breast asymmetry is a consult with Dr. Trussler in his Austin Texas plastic surgery office. This will help determine what breast procedure is right for you.

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A breast lift or mastopexy, is a very common procedure performed in plastic surgery. In its simplest form a breast lift repositions the nipple areola complex, or dark skin of the breast to a higher position, and reshapes the breast to eliminate sagging.

Who is a candidate for a Breast Lift?

A breast lift is designed for the woman who has lost the inherent support of the breast through stretching it out, usually through pregnancy, breast feeding, and/or weight gain and weight loss.

I have sagging of my breasts after breast augmentation, what can I do?

Breast implants do stretch the breast, and oversized implants stress the breast tissue and skin by adding excess weight to the breast. It is not uncommon that women seek a breast lift after an initial breast augmentation, either because:

• they needed a breast lift in the first place and a large breast implant was only placed
• the breast tissue stretched around the breast implant and has fallen off the implant giving a “snoopy” deformity.

Why does the breast sag?

The breast is typically supported by its external skin envelope and internal ligaments which connect the breast tissue to the chest. Over time, and with the effects of gravity these tissues can stretch, especially when excess weight is added to the breast as in pregnancy and lactation, and weight gain. This typically leads to:

• flattening of the breast
• sagging of the lower breast tissue
• drooping of the nipple areola

What are my breast lift options?

A breast lift can help reposition and reduce the stretched nipple areola to its more youthful position and shape. This can be done, while maintaining the sensation to the nipple in most circumstances. The sagging breast shape can be corrected by removing excess skin and bringing together flattened breast tissue. In a standard breast lift, the breast may lose volume or cup size because it is repackaged in a tighter breast envelope. If volume is to be replaced a conservative sized breast implant can be added to the breast lift procedure; this is referred to a mastopexy augmentation procedure. An auto-augmentation mastopexy is designed to repackage your own breast tissue into an implant shape that provides volume and firmness to the breast.

Do I need a breast implant with my breast lift?

Not every women seeking a breast lift is a candidate nor “needs” a breast implant. This is an individual decision based on goals of the procedure and your own breast tissue density. A breast lift will leave scars on the breast which may be around the nipple areola, down the center of the breast, and under the breast, or a combination of them all. Over time and with active scar care, these will fade.

Do I need to wear a bra after a breast lift?

After a breast lift, the woman should still wear a bra for support. The breast lift procedure by definition corrects the tissues that have failed and placing additional stress on these tissues again may cause recurrent stretching. This is especially true in the mastopexy augmentation patient who has replaced volume to the breast.

For more information on breast lift procedures you can refer to https://www.drtrussler.com/cosmetic-procedures/breast/breast-lift ‎or arrange for a consult with Dr. Andrew P. Trussler in his Austin Texas plastic surgery office.

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