Do You Need a Breast Lift? A Step-by-Step Guide

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Help – My Breasts Are Droopy!

Nude Hispanic woman examining herself in mirror
Rick Gomez/Blend Images/Getty Images

Have you thought about improving the appearance of your breasts? Do you wonder if you need a breast lift? How about a breast augmentation? Or do you need both procedures? How do you know which type of breast-contouring surgery you need?

It all depends on whether or not your breast skin needs tightening, if your nipple and areola need lifting, and if you want your breasts to stick out further from your chest.

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How to Tell If You Need a Breast Lift

Some women joke about being able to tuck their breasts into their pants! Most of the time, it is not quite that obvious. Women are the biggest critics of their bodies. You know every fluctuation in your weight. You know when you’ve lost even a little bit of volume from your breasts with weight loss or when your cup runneth over with a little weight gain.

And you certainly know when your breasts have lost the perkiness of your teen years. You may not know the medical terminology, but you know that something about your breasts just doesn’t look the same.

There are certain measurements that plastic surgeons use to determine if you need a breast lift, a breast augmentation or a combination of both. Don’t worry — you don’t have to have a medical degree and plastic-surgery training to do these measurements. If you know how to use a tape measure, you can do these measurements, too!

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How to Perform Breast Measurements

breast measurement landmarks
Landmarks for Breast Measurements: Sternal Notch and Nipple-Areola Complex. The red line indicates the distance between the sternal notch and the nipple. This distance helps determine which type of procedure(s) are necessary for breast enhancement. Photo © Millicent Odunze, M.D., M.P.H.

First, you will need to locate your sternal notch. The sternal notch is a groove at the base of your neck. It lies in the middle between your two collar bones (see photo above).

Place the "0" of the tape measure at the sternal notch, and then angle the tape at a diagonal in the direction of your nipple. Make note of that number. Repeat the measurement for the other breast.

Do not be alarmed if the measurements are not exactly the same. Some asymmetry of the breasts is quite normal.

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How to Interpret Your Measurements

Now for the fun part! You’ve done the measurements, now what do they mean? What type of surgery you need will depend on two factors:

  1. The distance between your nipples and your sternal notch.
  2. The location of the majority of your breast tissue in your breast – top versus bottom.

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If your sternal notch-to-nipple distances are 21 centimeters or less:

sternum to nipple distance 21 centimeters
Sternum-to-Nipple Distance 21 Centimeters or Less. Left: Breasts without Ptosis; Right: Breasts with Ptosis. Photo © Millicent Odunze, M.D., M.P.H.

If your sternal notch-to-nipple distances are 21 centimeters or less:

  • AND your breasts are not bottom heavy, you will not need a breast lift.
  • However, if you want your breasts to be larger in size you can augment them with your own fat or have breast implants.

If your sternal notch to nipple distances are 21 centimeters or less:

  • AND you have breast ptosis/sag (meaning the majority of your breast tissue is at the bottom part of the breast), you will need a breast lift.
  • For a larger breast size, you will need some type of breast enhancement. Breast implants or your own fat can be used.

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If your sternal notch-to-nipple distances are 22 to 23 centimeters or less:

sternum to nipple distance 22-23 centimeters
Sternum-to-Nipple Distance 22 to 23 Centimeters - Left: Breasts without Ptosis/Sag; Right: Breasts with Ptosis/Sag. Photo © Millicent Odunze, M.D., M.P.H.

If your sternal notch-to-nipple distances are around 22 or 23 centimeters:

  • AND your nipple and areola are in the middle of your breasts (not on the bottom portion), and your breasts are not bottom-heavy, you may not need a breast lift.
  • For bigger breasts, you’ll need some type of breast augmentation.

If your sternal notch-to-nipple distances are around 22 or 23 centimeters:

  • AND your nipple points toward the floor or is centered at the bottom part of your breast, you will need a breast lift.
  • If you desire larger breasts you can have augmentation with fat or implants at the same time as the breast lift.

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If your sternal notch-to-nipple distances are 24 centimeters or more:

sternum to nipple distance 24 or more centimeters
Sternum-to-Nipple Distance 24 or More Centimeters. Photo © Millicent Odunze, M.D., M.P.H.

  • You will need a breast lift to achieve the look of perky breasts.
  • For an increase in breast size, implants or fat can be used to augment the breasts.

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Breast Lift, Augmentation, or a Combination of Both

The above measurements are not absolutes, but are general guidelines to help you assess your breasts and the amount of sagging or droopiness you may have. There may be other factors that will guide your plastic surgeon in determining if you need a breast lift, a breast augmentation or a combination of both.

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