Our “girls” have quite a journey in life. Starting with our preteen years, we’re begging them to grow, eager to get that first bra – and then, we’re eager to have a bra bigger than our friends. (Never happened for me, alas.) Then, as we have babies, our breasts become more than just bra filler and man magnet – they become a source of sustenance to a tiny person! And we watch them inflate – only to later deflate, followed by sagging, much to our utter dismay.
The entire aging process can be seen, in all its depressing glory, through the eyes of our breasts. (Wait, imagine if breasts had eyes? Gross.) And the truth is, the decades aren’t always kind, so you better appreciate those “best breast” years!
The ticking of a clock… The size and shape of the female breast is, in large part, a reflection of a woman’s biologic clock – which is, in large part, under hormonal control. As such, its appearance changes with its ability to provide milk to her baby. Approximately two years after the onset of puberty (a girl’s first menstrual cycle), the hormone estrogen, in conjunction with growth hormone, stimulates the development and growth of the glandular, fat, and suspensory tissues that compose the breast. This continues for approximately four to six years or so until establishing the final shape of the breast (size, volume, density) when she is a woman of approximately 21 years of age
With every season…
Many of us see our weight fluctuate during these years as well, and often will sadly see our breasts be the first place to deflate when we lose weight – but not the first place to get larger as we gain. It’s not fair. The volume and shape of the breast will be mainly affected by weight changes reflecting the amount of fat in the breast
The hormonal changes associated with pregnancy also increase the size of the breast. During pregnancy, the breasts become enlarged and denser (firmer) because of the prolactin-caused organ hypertrophy, which begins the production of breast milk, increases the size of the nipples, and darkens the skin color of the nipple-areola complex.
After pregnancy, the breasts generally revert to their pre-baby size, shape, and volume. “Changes in the size and volume of the breast may permanently stretch the skin resulting in stretch marks and sagging (termed breast ptosis). Repeated pregnancies can aggravate the sagging and stretching.
At menopause, breast atrophy occurs. The breasts can decrease in size when the levels of circulating estrogen decline, followed by the withering of the adipose tissue and the milk glands. Breast ptosis, or sagging of the breasts, is a normal consequence of aging and is influenced by not only pregnancies, but also, higher body mass index, larger bra cup size, history of significant weight loss (>50 lbs.), and history of cigarette smoking.
So what would be our best breast years? It is clear that the best breast years are the 20’s and 30’s and even 40’s until the first pregnancy occurs with its concomitant hormone changes. Of course, massive fluctuations in weight can inflate and deflate the breast with concomitant stretching and sagging..
The fountain of youth Turning back the clock on our breast means reversing the sagging and stretching that accompanies pregnancy or significant changes in weight. It may also mean correcting the deflation that accompanies the aging process.
The solutions all involve breast surgery to restore shape to the breast. When the nipples and skin envelope sag (ptosis) but sufficient breast volume remains, a breast lift (mastopexy) is performed. This operation removes excess skin and repositions the remaining skin envelope to restore shape and nipple position. When there is loss of volume with minimal sag, a breast augmentation using either implants or fat taken from another area of the body can restore breast shape and volume.