‘Saggy’ Breasts Are a Normal Thing to Have—Here’s What To Know

As you age, it's normal for your breasts to sag and droop.

Throughout our lifetimes, our bodies undergo a lot of changes. One change in particular that you may have questions about is sagging breasts.

Drooping of the breast tissue is scientifically referred to as "breast ptosis." Although multiple risk factors are associated with sagging breasts, it is a naturally occurring phenomenon. However, there may still be a lot of shame and insecurity around this issue, even in an era of increased body positivity.

Here's what you know about causes, potential treatments, and some myths associated with breast sagging.

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What Causes Sagging Breasts?

The main reason for sagging breasts is stretching something known as the Cooper's ligament (also known as the suspensory ligament), a connective tissue made of collagen and elastin. 

The Cooper's ligament is mainly responsible for maintaining the structural integrity of the breasts and helping connect the breast tissue to the surrounding chest muscles. Various factors affect the integrity of that connective tissue, including the size of your breasts, pregnancy, age, and smoking.

Size of Your Breasts

"Stretching of the Cooper's ligament is seen more commonly in [people] with bigger breasts due to the gravitational pull," Anita Johnson, MD, a breast surgical oncologist at Cancer Treatment Centers of America, told Health

Likewise, research has suggested a positive relationship between larger cup sizes and sagging.

Pregnancy

Another one of the most common risk factors for sagging breasts is pregnancy, which is known to cause breast changes.

Among those changes is engorgement, which occurs due to hormonal changes. Post-pregnancy changes—including hormonal regression of the breast tissue—are among the most common reasons for sagging.

Age

Additionally, as people age, changes to the connective tissue can reduce collagen, leading to a loss of elasticity. Research has shown that aging leads to increased skin laxity, which weakens breast ligaments and leads to the sagging of breasts.

Also, as you age, your body produces less and less estrogen. Decreased estrogen causes your mammary glands, which normally produce breast milk, to shrink. As a result, your breasts lose their shape and become smaller than normal.

Smoking

Like the structural changes in aging, environmental factors, such as cigarette smoke, contain can break down the elastin in the skin. 

That's because smoking increases exposure to harmful substances called free radicals, including reactive oxygen and nitrogen species. Free radicals damage your cells, increasing your risk of chronic diseases. They also promote premature aging, including fine lines and wrinkles, which may impact the skin on your breasts.

Myths About Sagging Breasts

There are plenty of myths about what causes sagging breasts—including breastfeeding, wearing a bra, and exercising.

Breastfeeding

"Breastfeeding causing breast sagging is one of the most commonly circulated myths out there," Jennifer Lincoln, MD, OB-GYN and author of Let's Talk About Down There, told Health.  

Studies have demonstrated that one of the most common reasons that people opt not to breastfeed is that they do not want to alter the shape of their breasts due to misconceptions. In fact, some research has shown that following educational interventions about what actually causes breasts to sag, people felt more confident about breastfeeding.

So, while the number of pregnancies causes breast changes, no scientific study shows the link between breastfeeding and sagging. In other words, whether you breastfeed or not, the stretching of the Cooper's ligmaent that occurs during pregnancy is what actually causes sagging and drooping.

Wearing a Bra

Dr. Johnson added that wearing or not wearing a bra does not cause or prevent your breasts from sagging.

Still, many people do not wear the correct size bra. Research has suggested that ill-fitting bras can lead to increased pressure on your shoulders from tight bra straps, pain in your neck or back from a lack of adequate support, and upper limb neural symptoms (including weakness and limited arm movement).

So, although your bra won't do much for breast sagging, ensure you wear the right size.

Exercising

Numerous posts on the internet tell people how to prevent sagging with specific exercises. However, those exercises only affect the muscles in the chest, not the Cooper's ligament.

Likewise, research has suggested that exercising, including walking and running, does not cause your breasts to sag or droop at a higher rate than normal. However, it is good to wear a sports bra while exercising. Not supporting your breasts during high-intensity workouts may cause the skin of your breasts to strain more than normal.

So, you can still exercise for good health, but wearing a sports bra does more for breast health than the actual exercise itself.

How To Treat Sagging Breasts

A whole industry capitalizes on breast insecurity by selling lotions, creams, and special bras that supposedly help people prevent sagging. Still, only a few genuinely corrective options exist. Though sagging breasts aren't associated with any significant health problems, they can be corrected by breast lifts, a commonly done procedure.

Some people with sagging breasts may experience breast-related pain. However, that's more associated with the size of their breasts rather than the sagging itself.

"There is nothing to prevent sagging breasts. But one can opt for surgery, especially if they have debilitating back and shoulder pain due to bigger breasts," explained Dr. Johnson.

People can opt for breast reduction surgery if they wish to reduce the size of their breasts. Or, breast lift surgery (also known as mastopexy) is available to change the breast shape but not the volume. Some people also receive breast implants while undergoing breast lift surgery.

There are risks with every surgery. Aesthetic surgeries have a low incidence of significant complications (less than 1%). Still, many minor complications can occur—including asymmetry, deformity, and recurrence of sagging. 

Dr. Lincoln added that all sagging breasts are just as beautiful as those that are perkier. However, if a person feels treatment would improve their quality of life, should they experience back or shoulder pain from the size of their breasts, that's a valid option.

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