Best thing to do for saggy breasts?

The goal of mastopexy surgery is to produce an aesthetically pleasing, projecting breast that ideally maintains its improved shape over time. This can only be accomplished by some internal rearrangement of breast tissue which often involves removal and/or repositioning of lower pole tissue, and suture repair of the internal structure of the breasts. Unfortunately, the terms used to describe different mastopexy surgeries primarily refer to the surgical scars, and they do not communicate what technique is used to actually produce the lifted breast appearance.

Breast lift surgery (mastopexy is a surgery to lift the breasts. An important concept for prospective patients to understand is the fact that a breast lift which is a skin surgery only, when performed on breasts with significant volume and advanced ptosis (droopiness), is doomed to fail. Skin is elastic and stretches out when placed on tension, and is therefore unable to support the weight of the breast over time. A mastopexy that consists only of removal of skin excess without some internal rearrangement of breast tissue will inevitably result in a breast that appears bottomed out and once again droopy over time. A ‘bottomed out’ appearance refers to a breast where lower pole tissue has stretched out the lower pole skin, allowing the lower pole tissue to descend below the inframammary fold. Bottoming out of lower pole tissue also serves to ultimately make the nipple-areola complex appear too high on the breast, which is a distinctly unaesthetic mastopexy appearance and is to be avoided at all costs.

I strongly prefer to perform mastopexy surgeries primarily using a vertical mastopexy technique, which includes removal of excess lower pole tissue below the nipple-areola complex. Once the tissue is removed, the remaining medial and lateral lower pole elements are sutured together below the nipple-areola complex to tighten the lower pole and lift the breast. In patients who need additional upper pole fullness, the central lower pole tissue that would otherwise be removed can actually be mobilized but left attached to the chest wall at its base - which preserves its blood supply - and then advanced in a submammary pocket behind the upper pole of the breast where it is sutured to the chest wall to maintain its lifted position. This is referred to as an ‘auto-augmentation mastopexy’, and in appropriate patients it is an excellent technique for creating long-lasting upper pole fullness in a mastopexy patient who does not require (or who does not want) simultaneous breast augmentation using an implant, but who would benefit from additional breast volume locally in the upper poles.

Weight loss can result in saggy breasts. There are no exercises to improve the shape and postion of the breasts. The best option would be a breast lift. The breast lift will correct the position and shape of the breasts. If you have sufficient breast tissue, it can be enough to give you nice projection. If not, you can choose a breast implant to complete the result. A proper evaluation with a board certified plastic surgeon can help you find the best technique.