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'Saggy' Breasts Are A Totally Normal Thing to Have—Here's What to Know

Causes, treatments, and more.

Throughout our lifetime, the body undergoes 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," and although there are multiple risk factors associated with sagging breasts, it is actually 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, we've talked to some experts to discuss causes, potential treatments, and clear up some myths associated with breast sagging.

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What is the reason for sagging breasts?

The main reason for sagging breasts is due to stretching of something known as the Cooper's ligament (also known as the suspensory ligament), which is a connective tissue made of collagen and elastin. It is mainly responsible for maintaining the structural integrity of the breasts and helping connect the breast tissue to the surrounding chest muscles. There are various factors that affect the integrity of this connective tissue, including:

Size of the breasts: "Stretching of the Cooper's ligament is seen more commonly in [people] with bigger breasts due to the gravitational pull," board-certified breast oncology surgeon Anita Johnson, MD, tells Health. Other research has also shown the positive relationship between larger cup size and sagging.
Age: As people age, changes to the connective tissue can cause a reduction in collagen leading to a loss of elasticity. Studies have shown that aging leads to increased skin laxity, which weakens breast ligaments and leads to the sagging of breasts.

Number of pregnancies: This is one of the most common risk factors for sagging breasts. Pregnancy is known to cause breast changes, one of the most common factors being engorgement due to hormonal changes. Post-pregnancy changes (which include hormonal regression of the breast tissue) are one of the most common reasons for sagging.
Smoking: Similar to the structural changes seen in aging, cigarettes contain chemicals that can break down the elastin in the skin. Scientists have also found a positive correlation between smoking history and drooping in the breasts.

Does breastfeeding cause sagging?

Does wearing a bra have anything to do with making breasts sag?

It is maintained by scientists that wearing a bra does nothing to prevent sagging; it only aims to provide support. Dr. Johnson says that while wearing a sports bra during exercise can help for some, it doesn't do anything to prevent sagging. Similarly, not wearing a bra does not cause sagging.

Can certain exercises cause breast sagging?

There are numerous posts on the internet telling people how to prevent sagging with certain exercises. However, these exercises only affect the muscles in the chest, not the Cooper's ligament, the laxity of which is the main cause for drooping breasts. So one can still exercise for good health, but wearing a sports bra does more for breast health than the actual exercise itself.

What is the treatment?

There is a whole industry out there capitalizing on breast insecurity by selling lotions, creams, and special bras that supposedly help people prevent sagging, but only a few truly corrective options exist. Though sagging breasts aren't associated with any major health problems, they can be corrected by breast lifts, a commonly done procedure, according to plastic surgeons. Some people with sagging breasts may experience breast-related pain, though 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," says Dr. Johnson.

People can opt for breast reduction surgery if they wish to reduce the size of their breasts, or reconstructive surgery also known as mastopexy, which is aimed at changing the breast shape but not the volume. Other options include undergoing a mastopexy with implants.It should be noted that there are risks with every surgery. Aesthetic surgeries do have a low incidence of major complications (less than 2%) but there are many minor complications that can occur such as asymmetry, deformity, and recurrence of sagging. Dr. Lincoln reminds us that all sagging breasts are just as beautiful as those that are perkier, though if a person feels treatment would improve their quality of life—or any pain, should they experience back or shoulder pain from the size of their breasts—that's a valid option.

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