Contact Us

Why your breasts change – observations from the beach

As I lounged on the beach this weekend (with my SPF 50), my eyes wandered to all the breasts around me. It’s ok, because as I tell my wife, it’s all “research” and I assured her it was for my latest blog entry. Breasts can be found in a variety of shapes and sizes.

But the point is that the breasts that I observed are likely not the same size and shape that they were five years earlier. Breasts are extremely susceptible to changes – they change with age, weight, pregnancy, and breast feeding. To understand why, we have to examine the physiology of the female breast.

Why Your Breast Are Shaped the Way They Are

The internal support of the breast is composed of a network of dense collagen fibers termed “Coopers Ligaments.” This internal bra is responsible for maintaining the shape of the breast, independent of the quality of the overlying skin. As you age, the support structure naturally weakens. The weight of the breast also places strain on the ligaments, thereby “stretching” them over time. This is why it is rare to have naturally large, “perky” breasts. While there is no known way to “strengthen” Coopers Ligaments, wearing a well supporting external bra, especially during exercise, may delay the normal weakening that occurs as you age.

The actual composition of the breast is also important. The breast is composed of a combination of breast tissue and fat. The ratio between the two varies dramatically among women. Women who have heavy, dense breasts may have a breast tissue to breast fat ratio of 2:1. Women with soft, less dense breast have twice as much fat as breast tissue. This ratio between breast tissue and breast fat is very significant in how the breast changes and what breast contouring procedures you may require.

Breasts with a majority of dense breast tissue may be more likely to droop over time. This is because the weight of the breasts causes weakening of the internal support of the breast. As you age, the breast will continue to droop, making a breast lift necessary.

Breast Change With Hormonal Changes

Breast tissue will also change with hormonal changes. So, dense breasts may be more likely to enlarge during pregnancy and breastfeeding. After the hormonal surge of pregnancy is over, the breast tissue may shrink in a process called “post-partum involution”. Correction may require a breast augmentation with implants and sometimes a simultaneous lift.

Breasts with a majority of fat are lighter and less likely to droop. However, the fat in the breast is extremely sensitive to changes in your body weight. Gaining weight may cause your breasts to enlarge and this often does not regress if you are to lose the weight in the future. This may make a breast reduction necessary.

Breast fat is also not as sensitive to the hormonal changes of pregnancy, so enlargement and involution from pregnancy hormonal changes is unlikely. However, weight gain that often accompanies pregnancy may result in enlargement of the breasts. Conversely, weight loss can cause loss of fat in the breast, and make the breast “deflate”. Correction of this may require a breast enlargement with implants.

Breast Change Throughout Your Life

So, breasts size and shape will changes throughout your life. Understanding the internal support of your breasts, and the ratio of breast tissue to breast fat will help you anticipate these changes. Fortunately, breast contouring has evolved so that there is a procedure for virtually every complaint. New techniques allow for shorter incisions that are more easily hidden, and a more rapid recovery from surgery. Also, implant technology has evolved so that modern implants look and feel more natural, and are more durable then earlier generations of breast implants.

It is Possible to Get “Natural-looking” Breast Implants

Many women desire breast augmentation but decide not to have the surgery because they fear looking “fake.” There are ways to avoid having breasts that announce to the world that they are implants. It is possible to have breast augmentation surgery that gives a natural-looking result. Here are things to keep in mind:

  1. Breast Implant size – Implant size is important. It is generally thought that an increase in cup size of greater than 2 cups (an A to C, or B to D) will give an unnatural look. This is because the skin is stretched underneath the new breast implant and can prevent the natural softness and “droop” characteristic of a natural breast. Implant type – There are two choices for breast
  2. implants and these are saline or silicone.  Saline feels like a stiff, firm water balloon. If you do not have much breast tissue to cover the implant (which is probably why you are requesting implants to begin with) then your breasts can feel firm with saline implants.  On the other hand, silicone implants have a softer, jelly-like feel. These breast implants look and feel more natural, even beneath very small breasts in very thin women.  Ask your surgeon to see each breast implant type so that you can touch and feel the difference between saline and silicone. Currently in my practice about 90% of my patients choose silicone breast implants. Additionally, many women with saline implants have returned to exchange them for silicone in order to get a more natural look and feel.
  3. Implant position – Implants, regardless of the type, can be placed above or below the muscle.  By placing implants below the chest muscle, there is an extra layer of tissue to camouflage the breast implant. This gives the breast a more natural shape and helps to avoid a “stuck on” appearance of the breast. 
  4. Choose your new york city plastic surgeon wisely – You may choose an appropriately breast implant size, type, and position, but if you don’t choose an appropriate surgeon you can still have less than ideal results. Make sure to choose a board certified plastic surgeon with experience in cosmetic breast surgery.  Your surgeon should explain the different approaches to breast augmentation with you and help you choose an appropriate implant for your desire and body type. 

 So, despite some of the images you have seen in the popular magazines, “natural-looking” breast augmentation is possible in plastic surgery.  By carefully choosing the implant size, type, position, and surgeon, you should be able to achieve larger, natural-looking breasts.

Contact Our Office Today

If you are interested in learning more about a breast procedure, contact my office to schedule a consultation.