Dear Alice,

I've read your info about sagging breasts and whether to wear a bra, etc., but you don't say anything about what one can do after pregnancy after the skin is stretched out. Please tell me surgery is not the only answer!

Dear Reader,

Oh, for the love of those drooping dumplings! Unfortunately, there is no way short of surgery to tighten and lift breasts that sag from the effects of pregnancy, weight gain or loss, time, and/or the aging process. A woman's breasts change as she ages — just like the rest of her body changes. It's a normal process and happens to everyone. The good news is that making healthy lifestyle changes such as not smoking (which affects skin elasticity), maintaining a healthy weight, and getting regular physical activity can all contribute to maintaining a perky pair! Here's some more good news: While pregnancy can affect breast shape and volume, breastfeeding has not been shown to do so!

For all of the attention that they attract, breasts are really pretty straightforward. They're made up of three basic components:

  • Fat. The amount and distribution of fat determines the overall size and shape of breasts. When women are younger, their breasts have less fat and are mostly comprised of glands.
  • Glands. Responsible for producing milk, these milk glands expand and shrink in response to the hormone changes that accompany different stages of the menstrual cycle and pregnancy. They are mostly concentrated in the top outer portion of each breast, which is why this area can get tender and achy in the pre-menstrual phase. During pregnancy and before menstruation, the glands in the breast expand and become more sensitive. After pregnancy and menopause, these glands shrink and the breast becomes mostly fat tissue in composition.
  • Connective Tissue. This is the tissue responsible for the stretching you are experiencing. Breasts are supported by ligaments (a type of connective tissue) and skin. As breasts expand and then shrink during pregnancy and with age, the skin and ligaments that support the breasts can, as you've noticed, become stretched out, resulting in breasts heading south.

Because the muscles in the chest do not support the breasts, exercises that claim to "firm up" your chest area can indeed make the pectoral muscles under the breasts stronger and firmer, but do not lift the breasts themselves. Likewise, herbal remedies, creams, or lotions that are advertised to tone, enhance, or firm up breasts might make the skin on or around the breasts feel smoother or firmer, but cannot tighten skin or ligaments that have been stretched. Even "breast lift" surgery, which typically removes extra skin and tissue from the breast and tightens and lifts the remaining skin, or adds implants to maintain structure, is only a stopgap measure — "lifted" breasts will once again respond to the call of gravity as the skin and ligaments are gradually stretched over time.

Since there is no way short of surgery to tighten and lift breasts that sag from the effects of pregnancy, weight gain or loss, time, and the aging process, you may want to think about how critical it is to you to have gravity-defying breasts. While surgery is an option, rest assured that the size and shape of breasts change with age for every woman, whether she's been pregnant or not. If you are considering surgery, be sure to consider the costs and benefits for the procedure. Until then, may you and your beautiful breasts live a happy and healthy life!


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