Breasts change with age. They often lose firmness. And they become less elastic, which means the skin doesn't snap back into place after being stretched. There are many causes for these kinds of breast changes, including:

• Pregnancy. During pregnancy, the bands of tissue that support the breasts (ligaments) might stretch. This happens as the breasts get fuller and heavier. The stretching might cause sagging breasts after pregnancy. This may happen whether or not you breastfeed your baby.
• Weight changes. Changes in weight can cause the breast skin to stretch. It also can cause breast skin to become less elastic.
• Gravity. Over time, gravity causes ligaments in the breasts to stretch and sag.

A breast lift can reduce sagging and raise the position of the nipples. The surgery can also lift the darker areas surrounding the nipples (areolae). The size of the areolae may be made smaller to keep them in proportion to the newly shaped breasts.

You might consider a breast lift if:

• Your breasts sag — they've lost shape and volume, or they've gotten flatter and longer
• Your nipples fall below your breast creases when your breasts aren't supported
• Your nipples and areolae point downward
• Your areolae have stretched out of proportion to your breasts
• One of your breasts falls lower than the other

A breast lift isn't for everyone. If you plan to become pregnant in the future, you might delay getting a breast lift. Your breasts could stretch during pregnancy and offset the results of the breast lift.

Breastfeeding may be another reason to delay a breast lift. Although breastfeeding is usually possible after the procedure, it may be harder to produce enough milk.

While a breast lift can be done on breasts of any size, those with smaller breasts will likely have longer lasting results. Larger breasts are heavier, which makes them more likely to sag again.

A breast lift poses various risks, including:

• Scarring. While scars are permanent, they'll soften and fade within 1 to 2 years. Scars from a breast lift can usually be hidden by bras and bathing suits. Rarely, poor healing can cause scars to become thick and wide.
• Changes in nipple or breast sensation. Sensation typically returns within several weeks. But some loss of feeling might be permanent. Erotic sensation usually isn't affected.
• An uneven shape and size of the breasts. This could occur because of changes during the healing process. Also, surgery typically doesn't change breasts that were different sizes before surgery.
• Partial or total loss of the nipples or areolae. Rarely, the blood supply to the nipple or areola can briefly stop during a breast lift. This can damage breast tissue and lead to the partial or total loss of the nipple or areola.
• Trouble breastfeeding. While breastfeeding is usually possible after a breast lift, some might have trouble producing enough milk.

Like any major surgery, a breast lift poses a risk of bleeding, infection and an adverse reaction to anesthesia. It's also possible to have an allergic reaction to the surgical tape or other materials used during or after the procedure.

At first, you'll talk to a plastic surgeon about a breast lift. During your first visit, your plastic surgeon will likely:

• Review your medical history. Be prepared to answer questions about current and past medical conditions. That includes whether you have a family history of breast cancer.

  Share the results of any mammograms or breast biopsies. Talk about any medications you're taking or have taken recently, as well as any surgeries you've had.

• Do a physical exam. To determine your treatment options, the surgeon will examine your breasts — including the position of your nipples and areolae.

  The surgeon will also consider the quality of your skin tone. Breast skin that has good tone will hold the breasts in a better position after a breast lift. The surgeon may take pictures of your breasts for your medical record.

• Discuss your expectations. Explain why you want a breast lift. Be clear about how you want your breasts to look after the procedure. Make sure you understand the risks and benefits, including scarring and changes in nipple or breast sensation.

Before a breast lift you might also need to:

• Schedule a mammogram. Your surgeon might recommend a baseline mammogram before the procedure. You may also need another mammogram a few months afterward. This will allow your medical team to see changes in your breast tissue and interpret future mammograms.
• Stop smoking. Smoking decreases blood flow in the skin and can slow the healing process. If you smoke, it's important to stop smoking before surgery.
• Avoid certain medications. You'll likely need to avoid taking aspirin, anti-inflammatory drugs and herbal supplements, which can increase bleeding.
• Arrange for help during recovery. Make plans for someone to drive you home after surgery and stay with you as you begin to recover. You might need someone to help you with daily activities, such as washing your hair, during your initial recovery.
• Be at a healthy weight. Consider making dietary changes or doing an exercise program to assist with weight loss if you've gained weight in the past year.

A breast lift can be done in a hospital or an outpatient surgical facility. Sometimes the procedure is done with sedation and local anesthesia, which numbs only part of your body. In other cases, general anesthesia is recommended. You won't be awake if you're given general anesthesia.

During the procedure

Techniques used to remove breast skin and reshape breast tissue vary. The specific technique your plastic surgeon chooses will determine the location of the cuts (incisions) and the resulting scars.

Your surgeon might make incisions:

• Around the areolae — the darker area surrounding the nipples
• Extending downward from the areolae to the breast creases
• Horizontally along the breast creases

The surgeon might place stitches deep within the breasts to reshape the breast tissue. Stitches may also be used to reduce the size of the areolae. They remove excess breast skin and shift the nipples to higher positions. Then the surgeon brings together the breast skin . They close the incisions with stitches, surgical tape or skin adhesives.

The procedure typically takes 2 to 3 hours. You can go home on the same day.

After the procedure

After a breast lift, your breasts will likely be covered with gauze and a surgical support bra. Small tubes might be placed at the incision sites in your breasts to drain any excess blood or fluid.

Your breasts will be swollen and bruised for about two weeks. You'll likely feel pain and soreness around the incisions, which will be red or pink for a few months. Numbness in your nipples, areolae and breast skin might last for about six weeks.

In the first few days after a breast lift, take pain medication as recommended by your health care provider. Avoid straining, bending and lifting. Sleep on your back or your side to keep pressure off your breasts.

Avoid sexual activity for at least 1 to 2 weeks after the breast lift. Ask your health care provider when it's OK to resume daily activities, such as washing your hair, showering or bathing.

Drainage tubes may be placed near your incisions and are typically removed within a few days. When your health care provider removes the tubes, they will also probably change or remove your bandages.

Talk to your provider about when — or if — your stitches will be removed. Some stitches dissolve on their own. Your provider must remove some types of stitches, often 1 to 2 weeks after the procedure.

Keep wearing the surgical support bra round-the-clock for 3 to 4 days. Then you'll wear a soft support bra for 3 to 4 weeks. Your health care provider might suggest using silicone tape or gel on your incisions to promote healing.

While you're healing, keep your breasts out of the sun. Afterward, protect your incisions during sun exposure.

You'll notice a change in the appearance of your breasts right away. Their shape will continue to change and settle over the next few months.

Initially, scars will appear red and lumpy. While scars are permanent, they'll soften and become thin within 1 to 2 years. Scars from a breast lift can usually be hidden by bras and bathing suits.

You might notice that your bra size is a little smaller after a breast lift. That may happen even if you haven't had a breast reduction in combination with the procedure. This is simply a result of your breasts becoming firmer and rounder.

Breast lift results might not be permanent. As you age, your skin will naturally become less elastic. Some sagging might occur, especially if you have larger, heavier breasts. Keeping a stable, healthy weight can help you retain your results.