Sagging of the breasts is a common development for most women due to aging, pregnancy or weight loss. It is most severe with multiple pregnancies or significant amounts of weight loss. While corrective breast lifting is most frequently performed with implants to restore and even increase original breast volume, it can also be done alone when the woman requests to just ‘put them back where they once were’.
Many women assume that a breast lift will also make their breasts more perky as well as fuller in the deficient upper pole. While this may be true for some women who have more sagging than breast tissue loss or a lot of volume that has fallen over the inframammary fold, this is not necessarily so for most women with breast sagging.
In the July 2014 issue of the Plastic and Reconstructive Surgery journal, an article was published entitled ‘The Impact of Mastopexy On Brassiere Cup Size’. This article was a clinical study that evaluated the change in bra cup size in women who had undergone breast lifts. Over a nine year period from the perspective of a single surgeon, twenty women who had underwent mastopexy alone (breast removed less than 150 grams per side) were surveyed regarding before and after surgery cup size, changes in bra manufacturer and weight gain/loss. The majority (80%) had grade II ptosis while the remainder had Grade III. Average breast tissue removed was almost 60 grams. (minimal) Average change in bra cup size was a decrease of 1.05 cup sizes.
This study demonstrates what plastic surgeons know based on a lot of observational experience…a breast lift will make one’s breasts look smaller. They will be more uplifted and have variable degrees of perkiness but they will be smaller both by appearance and in actual bra cup size. This occurs because in most cases of breast sagging the actual breast volume is less than the actual cup size a woman is wearing. This phenomenon is often called the ‘rock in the sock’ effect as the skin sleeve is bigger than what is inside of it. But when the breast is lifted and tightened, the bra cup size usually decreases despite teh fact that little to no breast volume has been removed.
As this study shows, breast lift surgery alone results in an average drop of one bra cup size. This is important to preoperatively appreciate as maintaining the same breast volume (or to even end up slightly bigger) may require an implant to be combined with the lift.
Dr. Barry Eppley
Indianapolis, Indiana