What can be done about my saggy breasts?
Dear Dr Mitchell,
I am a 38-year-old married woman and mother of two. After my first baby I noticed that my breasts were no longer firm and have sagged and are flat with stretch marks at the top. I have to be careful when I am wearing sexy/strap blouses or dresses. This has caused me to feel insecure. I realise that when I take oral contraception it cause my breast to become firm and fuller, however I have fibroids and whenever I take the pills it causes my menstruation to be extremely heavy and it takes weeks to stop. I have decided to have the surgery to remove them. My question is, are there any recommendations apart from breast implants to help my breasts to become firm and full again?
It is not unusual as women get older for the breasts to become flat and sag a bit. The sagging of the breasts is due to stretching of the supporting ligaments of the breasts. This is not necessarily due to the fact that you have two children and breastfed them both. Women who do not have children and who do not breastfeed can also develop sagging of the breasts.
Stretch marks may occur as the breasts increases in size during pregnancy, lactation or even when women gain weight. The risk of this happening depends on your skin type. It is quite a common thing to have stretch marks on the breasts and this is seen in women of all ages. This should not cause you to feel insecure and should not prevent you from wearing strap blouses or dresses. If you look around it is the order of the day to see women with stretch marks on the arm, breasts and thighs. This does not take away from your inner or outer beauty. You should just wear your outfits with confidence.
If you do not need the oral contraceptive pills for contraception, you should not take it simply to increase the size of your breasts. Anyway, increase in size does not usually last for a long time. The use of the oral contraceptive pills usually reduces the menstrual blood flow and reduces the risk of developing iron deficiency (anaemia) from excessive blood loss. The fact that your flow increases in amount when you go on the pills is significant and you need to have further evaluation done.
It is important to have an ultrasound done to check the lining of the uterus to see if it is excessively thickened. This excessive bleeding may be an indication of endometrial hyperplasia, endometrial polyps or even cancer of the lining of the uterus. It is unsafe to continue the birth control pills until you have been properly evaluated. This evaluation is important whether you plan to remove the fibroids alone or to remove the entire uterus. Sampling of the lining of the uterus by a dilatation and curettage may be necessary prior to doing any definitive surgery.
Breast implants do help to give you a fuller and firmer look to the breasts and improve your appearance in your outfits. This can be done as an outpatient procedure and requires very little anaesthesia. We do have excellent plastic surgeons in Jamaica who have had excellent results and happier women with a boost in their self-esteem and self-confidence. These procedures however, do have risks involved although complications are not common and sometimes the procedure has to be repeated several years later since the implants do not last forever.
You should consider wearing padded brassieres with good supportive straps and this will give you a fuller form in your outfits. Discuss this with your husband and see how he feels. If you still think that you are unhappy then consult a plastic surgeon who will advise you further about your options.
