Everybody knows that your face tells a story. It tells the world a little about how old you are, how much sun you’ve gotten, and maybe even how stressed you’ve been. The quality of your skin also suggests how healthy you are, how well you take care of yourself, and how much time you have for facials. Similar information can be gleaned from the condition of your hands and the natural curve of your waistline. But few people, even plastic surgeons, recognize the impact that your breasts can have on how old or how fit you may look.

Here are several ways your breasts convey your age, and how, with artful cosmetic surgery, you can erase the years.

Perky: Why The Cleavage Line Is Key

Anatomically, the breast is divided into quadrants, or quarters. The upper-inner quadrant is the critical portion of the breast, from both a cosmetic and a sexual standpoint. This is your ‘cleavage’ line, or the part that sticks out of your v-neck sweater. The interesting thing about the upper-inner quadrant is that the bigger your breasts are, and the lower they hang, the higher the likelihood that most of your volume is hanging at your waist rather than sitting up at your cleavage line. A good bra can help to reposition some of this tissue,  but it still often results in a shelf support effect rather than a real illusion of perkiness.

One of the most important goals of a breast reduction or breast lift operation is the repositioning of tissue to the upper inner quadrant to recreate a youthful and stable cleavage line.  There are many different techniques that end with a smaller breast, but only a few that focus on re-sculpting the remaining tissue into something any 25 year-old would be proud of. This is where artistry comes into play when it comes to plastic surgery.  Granted, taking off excess weight is key to the medical component of the procedure, but restoring form and contour is what truly creates patient satisfaction. Why not do both if you can? A properly performed breast sculpting procedure can literally take years off your appearance,  especially when you’re naked. An expertly performed reduction or lift can restore long-term support, even many years later.

Why Size Matters—And Bigger Isn’t Always Better

One of the main complaints I get from patients who come in requesting breast reduction surgery is that they have back and neck pain. But the second thing they report is that they feel “heavy.” That is probably the best way to describe a woman who has way too much breast for her frame, as well as the best way to describe what effect that heaviness has on her overall physique. Simply put, big breasts make you look bigger than you really are.

One of the most dramatic effects of a breast reduction surgery is that, for some patients, it actually makes them look like they lost 20 pounds. Large breasts not only add real weight, but they also impose larger clothing that is disproportionately bigger than the woman’s actual size. What’s more, the top-heavy nature of the problem often translates into poor posture, which also creates an illusion of stalkiness, and even more weight. Removing one pound of breast tissue can mimic losing ten, and downsizing shirt sizes by two units. But the other interesting thing about large breasts is that the bigger they are, the lower they hang; and the lower they hang, the older they make you look.

Everybody has that image in their head of a typical old-school grandmother, the sweet plump woman who could cook anything and whose undergarments were literally larger than life. In a culture that venerates large breasts, why is it that grandma’s big bosoms are not the be all and end all?  The answer is simple: they fall to her knees. But the other part of the answer is that size isn’t everything.

Nipple Positioning: High Vs. Low

We now know that size and position can influence how old your breasts look,  but what about the nipple? Nipple position is closely related to sagging, and a low hanging breast almost always has a low lying nipple. Any reduction or lift procedure should aim to reposition the nipple-areolar complex up where it belongs: right at the level of the breast fold. This is where the nipple lives in a healthy young woman, and this is where it can return after being lost, with a properly performed procedure. In many ways, the nipple is the face of the breast much as the belly button is the face of the belly.  Even a beautiful breast will look less pretty,  and sometimes even strange, with the nipple in the wrong spot.

All About The Areola

The final element that can make your breasts look old is the size of your areola.  A wide areola suggests age and someone who has nursed many children, and that was long ago. Almost all breast reduction or lift procedures involve resizing and reshaping the areola, creating a cute round shape that is harmonious with the rest of the breast. Once again, not all techniques are equal, and many of these procedures can inadvertently result in an oval or teardrop shaped nipple complex. But a keen awareness of the forces at play and attention to detail can result in a beautiful crown for a perky new breast. This is where the rest of the artistry comes into play.

These Changes Can Make a World Of Difference

Few aspects of human anatomy are as intimately associated with femininity as the breasts, and few elements of the female body undergo as many changes as they do throughout a woman’s lifetime. People don’t often think about breast surgery when they think about a rejuvenating procedure, but they should. Lifted and proportional breasts are the cornerstone of a fit physique, along with a taut waistline, which is why these procedures are the basis of the ‘mommy makeover.’ What’s more,  lightening the load often allows women who want to exercise to actually do that, leading to a better figure overall. After all, it is a lot easier to go for a jog when you no longer have two five pound barbells hanging from your neck.

Most of my breast reduction patients report that their surgery was merely a springboard to a whole new lifestyle and a rediscovery of themselves. To this day, they still represent some of my happiest patients across the board. One of my patients told me that she went home after the procedure and her son said, “Mommy, you look taller!” and she realized that she had never stood up that straight before. Those stories make it all worthwhile. But the victorious moment for me is putting the before and after photos side by side and marveling at the fact that the one on the left looks like she’s 60 and the one on the right looks like she’s 30, and they’re the same person three months apart.

Dr. Sophie

as featured on CharlottesBook.com