How Do the Breasts Change Postpartum (After Pregnancy)?

I am often asked by patients about changes in the breasts due to previous pregnancies and breastfeeding. In fact, a significant portion of cosmetic plastic surgery of the breast and body that I perform can be linked back to pregnancy, childbirth, and breastfeeding. Unfortunately, pregnancy is tough on a woman’s body, and many changes are irreversible and unavoidable. However, not everyone is affected! There is a significant genetic component to these changes, and as a guide, you can look to your mother’s experience and postpartum changes.

When pregnant, the breasts get larger and swollen due to hormonal changes and weight gain. In general, after pregnancy the breasts often lose their round shape. Postpartum the breasts remain swollen when breastfeeding, but as a woman loses weight after pregnancy, they typically “deflate”. When deflating, the breasts lose volume from both the upper and lower pole of the breast. In severe cases, the breasts become “pancake”-like. The breasts also sag, and the amount of sag depends on initial breast size, pregnancy weight gain, subsequent weight loss, and genetics. There are three grades of ptosis (sagginess):

• Grade I Ptosis: at the level of the inframammary fold (the bottom crease where the breast meets the chest wall) or higher. Technically this means mild to no sag.
• Grade II Ptosis: Nipple below the inframammary fold
• Grade III Ptosis: Nipple on the most dependent part of the breast (lowest part) and points downwards

The good news is that this sag and deflation can be corrected by a breast lift, or mastopexy, which is one of the plastic surgery procedures I perform. To view examples of postpartum breast sag and deflation, take a look at the before photos from my before and afters for mastopexy: Breast Lift / Reduction Before & After.

If you desire an increase in overall size of the breast as well as a lift, I can also perform a breast augmentation combined with a breast lift in what is called an augmentation mastopexy, or aug/pexy for short. Another common combination is the mommy makeover: a breast lift (or augmentation) combined with a tummy tuck or liposuction of the abdomen and flanks.