Most women’s breasts lose their perk with age and extremely large-breasted women will be affected earlier and to a certain degree. But the reasons aren’t related to ligaments or even strictly dependent on breast size. Much more important are inherited characteristics such as skin elasticity and breast density which reflects the ratio of lightweight fat to heavier glands.

There is the tendency for older women to show sagging of the breasts. The sagging is caused by partial deterioration of the glandular tissues that produce firmness of the breasts and some stretching of the tissues connecting the breasts to their muscles. Measures may be taken earlier in life that may prevent, or at least reduce, sagging later in life. They include wearing supportive brassieres during pregnancy, breast feeding, and exercising.

Breast sagging occurs for several different reasons - multiple pregnancies, breast feeding, rapid weight loss, genetics, gravity and age.

Just as all body tissues are susceptible to the effects of gravity over time, the breast, because it is an external organ and not protected from external forces, also undergoes changes over time. The connective tissues supporting the breast are always under constant stretch due to the effects of gravity on the weight of the breast, this effect eventually causes the relaxation of these supporting ligaments creating the sagging effect. Breast feeding is another contributor to breast sagging because of the expansion and contraction of the breast tissue over months of breast feeding eventually results in drooping breast changes in susceptible women. Other women may be prone to ptosis because of changes in weight, genetics or multiple pregnancies.

Another reason for breasts sagging is the lack of the hormone estrogen, which occurs at menopause. This reduction in estrogen affects all the tissues of the body, including breast tissue, and results in a reduction in size and fullness. The milk secretion process is also halted by this time. Much of the connective tissue in the breast is composed of a fibrous protein called collagen, which needs estrogen to keep it healthy. Without estrogen, it becomes dehydrated and loses it's elasticity.

Both during pregnancy and as you reach menopause - make breasts sag even more. During pregnancy, the hormones estrogen and progesterone, which are secreted by the ovaries and the placenta, stimulate development of the 15 to 20 lobes of milk-secreting glands embedded in the breast's fatty tissue. These changes are permanent. And although the glands may be empty after they're no longer needed to produce milk, they will still add bulk and firmness to the breast. Once menopause arrives, however, the drop in estrogen and progesterone signal the breast that its milk ducts and lobes can retire. As a result, the breasts shrinks, add fat and begins to sag over and above the demands of gravity. Fortunately there are three ways to prevent, and sometimes reverse, both saggy and stretch marks breasts.

Premature sagging occurs as a result of stretching the Cooper's ligaments that help suspend and support the breast. Breast ptosis can result from a loosening of the skin and suspensory ligaments. Gravity and weight of breasts take their toll over time. Ptosis can also come from a reduction in the volume of breast tissue. This can occur after pregnancy and weight loss .

One of the reasons for sagging breasts is age! As we age, our skin ages too. It does not hold things up as well as it did when we were young, becasue it has lost some of its elasticity. The older we get the less elastic our skin becomes. Thats why so many older women have sagging breasts.

If you are a young woman with breasts that are sagging, it may be for several other reasons. If you are not getting enough support from your bra or not wearing a bra at all, your breasts can start to sag due to lack of support. This is especially true for larger breasted women, and women who may be participating in sports without the proper sports bra. The third reason for the onset of sagging breasts in some younger women is change in overall breast size after having a baby. A woman's breasts generally become larger and engorged with milk in preparation for breastfeeding. Once breastfeeding is over, her breasts may not snap back.

As we age, after pregnancy (or exposure to breast growth due to hormones) or weight gain then loss, we experience atrophy of the breast tissue and it's envelope. From pregnancy or hormone-induced gain then loss -- this loss is called involution. From weight gain, then loss -- this is from the body losing the filling and fat which it had prior to the weight loss. Aging is merciless and we start losing collagen and elastin and the breast envelope begins to thin, weaken and eventually - becomes ptotic (saggy).

After our breasts enlarge due to pregnancy they usually shrink postpartumly. Other changes result from having breastfed, estrogen and progesterone supplementation in the form or shots, implants or medications, hormonal disorders, menopause and lastly age. As we age our skin thins, we lose breast volume due to the shrinking of our lobules due to a decrease in hormones. We also lose body fat in areas where we want it, and seem to somehow selectively gain it where we do not.

DIFFERENT LEVELS OF SAGGING

There are certainly varying degrees of ptosis which only need certain smaller lifts for correction and other cases which need a full lifting. Following are the most commonly described ptotic grades to help you better determine what you may need.

HOW TO TELL YOUR DEGREE OF PTOSIS .

Determine your mammary crease as it is directly underneath the breasts. These two levels may be higher than one another. You can use a ruler if you wish it. The highest part of the ruler should be directly against the junction of the breast and ribcage.

	Mild Ptosis If the central point of your nipple (not your areola) is slightly above or directly in front of the top of this ruler (your breast crease) - you may have Grade 1 ptosis. Very mild to mild ptosis usually needs only a crescent lift.
	Mild to Moderate If the central point of your nipple (not your areola) is 1 - 3 cm below the top of this ruler (your breast crease) you may have Grade 2 ptosis i.e. Mild to Moderate Ptosis .
	Savere Ptosis If the central point of your nipple (including your areola) is more than 3 cm below the top of this ruler (your breast crease) you may have Grade 3 ptosis i.e. Severe Ptosis.
	Pseudo - ptosis Psuedo-ptosis is when your nipple is still slightly or well above your inframammary crease but it still appears droopy due to the presence of a significant, but somewhat flattened, breast lobe. Usually persons with pseudo-ptosis have smaller areola complexes which did not stretch during the pregnancy or weight gain.
	Mild Ptosis, Asymmmetry Even though you pass the "tests" above you may still feel as though your breasts are too low on your chest wall or that your areolae have stretched out.
	Low Breast Like said above, some women's breasts actually sit on the chest wall lower. They have no ptosis, have good volume and a proper infra-mammary crease, BUT - the entire breast complex is rather low on the torso.

	This is the perfect breast shape.
	The "swooping" breast is actually pretty common. Some maybe be due to lack of volume but no sag - it is actually among the better of the shapes to have if you're going to get implants. The nipples point upwards which is major asset in breast augmentation surgery. Of course breast shape can be hereditary.
	The ptotic, (saggy) breast with some volume is also very common. Usually after a pregnancy you will lose volume, have enlarged areolae and thinned skin due to stretching during the pregnancy. Breast feeding can affect the nipple structure as well - causing it to elongate.
	The ptotic, (saggy) breast with little to no volume is very common after pregnancy, breastfeeding, weight loss and aging - or all four combined. Although many young mothers may experience this after pregnancy and breast feeding, where aging is not a factor. However it is truly dependent upon the individual.
	The ptotic, (saggy) breast with much volume will more than likely need a lift.
	This case is more common than you think.
	This is more of a breast anomaly than a shape. Often called "Tubular breasts" or "constricted breasts".
	This shape is usually due to herniation of the tissue, lobules and fat without proper containment by the connective tissue under the areolae complex.
	Pectus carinatum congenital chest deformity (pigeon chest) with ptosis: This isn't exactly a breast shape, per se, but rather a "deformity" or divergence of the chest. The ribs usually protrude as can the sternum. Sometimes the ribs stick out much further than the sternum causing lack of self esteem or self consciousness of the breasts.