Breast lifting may decrease bra size

New study says average decrease is one cup size

June 1, 2014
American Society of Plastic Surgeons (ASPS)

After undergoing breast lift surgery (mastopexy), women may find themselves wearing a smaller bra, with an average decrease of one bra cup size, reports a study in the July issue of Plastic and Reconstructive Surgery, the official medical journal of the American Society of Plastic Surgeons (ASPS).

But the difference reflects the effects of the breast lift itself, rather than a true reduction in breast size, according to the study by Dr. Katie Elizabeth Weichman of New York University and colleagues. They believe their results have important implications for talking to patients about the expected results of a breast lift.

Cup size goes down after breasts are lifted

Breast lift is a popular cosmetic surgery procedure, performed in nearly 90,000 women in the U.S. in 2012, according to ASPS statistics. Breast lifts restore a more youthful and lifted appearance in women with sagging of the breasts due to aging, pregnancy, breastfeeding, etc.

The researchers performed a follow-up survey of 20 women who underwent a breast lift at an average age of 47 years. All patients underwent breast lifting only, with no significant breast reduction or augmentation. Five years later, the women were asked about their bra cup size before versus after breast lift surgery. Weight change and other factors that might affect bra fit were also evaluated.

The women reported an average decrease of approximately one cup size, e.g., from a D to a C cup. All of the women reported no change in bra manufacturer, an important consideration since sizing can differ between brands.

One patient reported a substantial increase in cup size, but this seemed to be related to hormone therapy and weight gain. All of the women said they were satisfied with the results of their breast lift surgery.

Bra fit closer to 'true' cup size after breast lift

If surgery only lifted the breasts rather without changing their size, why did cup size decrease? The answer has to do with correct bra fit and patient comfort, Dr. Weichman and coauthors believe. "It is well known that most women do not wear the correct bra size," they write.

Because of excess skin and soft tissue, women with breast sagging may be more comfortable with a looser-fitting bra. The researchers write, "It is our contention that ptotic breast fills out a larger (than actual) brassiere cup size." After their breasts have been lifted, women may choose a smaller cup size for reasons of comfort.

The findings have important implications for setting patient expectations, especially because most patients considering a breast lift want to improve the shape of their breasts without changing the size. "Consequently, conveying to them at the initial visit, that lifting alone will result in a smaller cup size avoids the potential for over reducing and patient dissatisfaction," Dr. Weichman and coauthors write.

"We encourage patients to consider their true preoperative cup size to be smaller than what they currently wear," the authors added. They suggest a technique that the plastic surgeon can use - simply elevating the breast with the thumb and forefinger - to give women an idea of the expected results after mastopexy, as well as showing them their true bra cup size.

Dr. Weichman and colleagues note that their patients were on average of low-normal body weight and wore at least a C cup size before surgery. The findings therefore may not apply to heavier women or those with smaller breasts.