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