Dear Reader,

For all of the attention that they attract, breasts are really pretty straightforward — they're made up of three basic components:

Fat The amount and distribution of fat determines the overall size and shape of breasts. When women are younger, their breasts have less fat and are mostly comprised of glands.

Glands or Lobules
Responsible for producing milk, these milk glands expand and shrink in response to the hormone changes that accompany different stages of the menstrual cycle and pregnancy. They are mostly concentrated in the top outer portion of each breast, which is why this area can get tender and achy in the pre-menstrual phase. During pregnancy and before menstruation, the glands in the breast expand and become more sensitive. After pregnancy and menopause, and as a woman continues to age, these glands shrink and the breast becomes mostly fat tissue in composition.

Connective Tissue
Breasts are supported by ligaments (a type of connective tissue) and skin. As breasts expand and then shrink during pregnancy and with age, the skin and ligaments that support the breasts can, as you've noticed, become stretched out, resulting in breasts heading south.

Because the muscles in the chest do not support the breasts, exercises that claim to "firm up" your chest area can indeed make the pectoral muscles under the breasts stronger and firmer, but do not lift the breasts themselves. Likewise, herbal remedies, creams, or lotions that are advertised to tone, enhance, or firm up breasts might make the skin on or around the breasts feel smoother or firmer, but cannot tighten skin or ligaments that have been stretched. Even "breast lift" surgery, which typically removes extra skin and tissue from the breast and tightens and lifts the remaining skin, or adds implants to maintain structure, is only a stopgap measure — "lifted" breasts will once again respond to the call of gravity as the skin and ligaments are gradually stretched over time.

Since there is no way short of surgery to tighten and lift breasts that sag from the effects of pregnancy, weight gain or loss, time, and the aging process, you may want to think about how important it is to you to have gravity-defying breasts. Is it enough to find a supportive bra that gives your sweaters that ripe melons look? Would exercise to firm other areas (such as your abs or glutes) help you feel better about your body as a whole? Or, is it important enough to have perky peepers that the costs and potential risks of surgery are worth it? These are not easy decisions, but gathering information, talking with a health care provider, and careful thought may help you decide.

Alice

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