Five Reasons A Woman’s Breasts May Sag


A breast lift, as NYC-based plastic surgeon Dr. Kaveh Alizadeh tells his patients, differs from a breast augmentation in that while an augmentation adds volume to make the breasts appear fuller and rounder, a breast lift’s goal is to correct sagging—technically known as ptosis. There are many reasons a woman may experience sagging, ranging from motherhood to weight loss to the passage of time. Here are five conditions that can contribute to the condition: 


While pregnant, a woman will find that hormones trigger physical changes in anticipation of the coming baby. One of the most noticeable transformations is the development of larger breasts as milk glands grow. This typically begins just more than a week after the baby is conceived, when the newly forming placenta begins to release a chemical known as human chorionic gonadotropin. Though every woman is different, with some experiencing virtually no visual change to their breasts at all, others will find that they have gone up two cup sizes. Breast skin stretches to accommodate this new volume, and many women see the development of stretch marks to prove it. Larger breasts generally shrink back down again, eventually, once the hormone fluctuations stabilize and the body returns to its normal state. As the milk glands shrink and volume goes down, the stretched skin and the underlying Cooper’s ligaments can lead to loss of support and sagging. 


Women who breastfeed their babies will find that their breasts can grow even more once they begin actually producing milk. All mothers who give birth will likely experience some shift in size, since the placenta’s detachment triggers a new release of hormones aimed at boosting milk production. As a newborn baby nurses, the process encourages continued production, which can lead to very full—and large—breasts. Some women find that they have to shop for new bras, even if they already went up a size or two during their pregnancy. The increase in volume can be so significant and rapid, the breasts can become hard and inflamed due to being engorged. As with pregnancy, the volume increase should be temporary. Once breastfeeding stops, milk production will dwindle and cease, leading to a corresponding reduction in volume. This can create even more stretched skin and loss of support from the underlying Cooper’s ligaments

Weight Fluctuations

A common pattern to many cases of breast ptosis is the development of volume in the breasts, followed by its loss at a generally rapid pace. Women who have gained weight and have correspondingly lost it may find that shrinking fat cells leave behind telltale evidence in the form of stretched-out skin. The speed at which weight loss happens is often the problem, since a relatively fast transition from more to less volume may not give the skin enough time to keep up with changes. The result can be a deflated, sagging breast. This problem is common to women who choose gastric bypass surgery or other surgical weight loss strategies that can cause dramatic changes in a short amount of time.


A person’s skin changes over time, becoming less elastic and supportive as collagen, hyaluronic acid, and elastin levels drop due to environmental forces and a natural slowdown in production of support hormones. Healthy, youthful skin keeps various features well supported, some the round apples of the cheeks to perky breasts. As women get older, their skin is less able to provide that natural support, leading to shifts in contours and silhouettes. Couple this with the never-ending downward pull of gravity, and sagging is likely.


Unfortunately, some women will find that their breasts sag simply because their genes tell them to do so. Heredity can determine how elastic someone’s skin is, how dense their breast tissue is, how large their breasts will grow, and how fat is distributed throughout their body. All of these elements can contribute in some way or another to sagging.

 Addressing the stretched-out skin and creating internal support for the breasts can correct ptosis by helping the breasts to sit higher on the chest. Learn more about specialized breast lift techniques by contacting Dr. Kaveh Alizadeh, who pioneered the NaturaBra™ Breast Lift. This procedure involves using a patient’s own tissue to create an “inner bra” anchored to the ribcage for a lifetime of support. The hammock-like result of this technique sets it apart from other, more typical lifting procedures that leave the breasts to gradually sag again over time—sometimes in as little as a few years after the initial surgery. He has also combined this operation with fat grafting to the breasts in cases where the patient wants her own tissue to enhance the superior pole or cleavage.


Send a message online or call Dr. Alizadeh’s Cosmoplastic Surgery offices in Long Island (516.439.5010) or Manhattan and Westchester (212.348.0100).