[Case Review] Liposuction Breast Reduction for Breasts That Sag After Childbirth
In consultations, I often hear things like "After having my baby, my breasts got smaller and started to hang down," or "Since I lost weight, only my breasts look droopy." Many women tell me that their breasts have less volume than before yet have stretched downward, so their bras no longer give a nice shape and their clothes do not fit the way they used to.
Today, using a case, I would like to explain how liposuction can be used to refine breasts that sag after childbirth or weight loss. In particular, I will go over how the superficial liposuction and micro-liposuction we use together at Venus Clinic encourage the skin to contract, and how textbooks and papers describe this, with the sources listed.
Why Breasts Sag as They Get Smaller
The breast is made up of glandular tissue, the fat that fills the spaces in between, and the skin that wraps around all of it. Because it contains a lot of fat, its size changes as body weight goes up and down. The problem is that when the breast gets smaller, the skin that was covering it cannot shrink at the same pace.
As Weight Drops After Childbirth
During pregnancy, the breasts naturally grow larger as body weight increases. After childbirth, as the extra weight comes off, the enlarged breast volume also shrinks, but skin that has been stretched once cannot shrink back by the same amount. As a result, the inside becomes empty while the extra skin remains, so the breasts hang downward and take on a shape that is not cosmetically pleasing.
Also After Rapid Dieting
Dieting that takes off a lot of weight in a short time causes similar changes. When weight drops, fat in the breasts, along with the face, is often among the first to decrease, so the breasts become smaller while the skin stays stretched, making them look droopy. Women who say their body feels lighter but only their breasts look deflated usually fall into this group.
Liposuction Can Be Considered for Sagging Breasts Too
Many people think liposuction is not suitable when the breasts sag. At Venus Clinic, however, we consider sagging breasts to be candidates for liposuction as well. This is because when breast volume decreases, the weight pulling the breast down becomes lighter, and evenly suctioning up to the superficial layer encourages the skin to contract, which helps improve the sagging as well. Rather than thinking of "surgery to reduce size" and "surgery to treat sagging" as separate things, we approach it as a question of how to refine the tissue that stays so that the skin can wrap around it again.
Superficial Liposuction and Micro-Liposuction
With sagging breasts, what determines the result is not how much fat is removed but how evenly fat is left beneath the skin. Liposuction is not surgery to remove a lot of fat; it is body contouring surgery that leaves fat well, and the basic principle is to leave the remaining fat layer uniform. To do this, Venus Clinic performs superficial liposuction and micro-liposuction together.
Superficial Liposuction — Evenly, Up to the Layer Near the Skin
Standard liposuction mainly removes fat from the deep layer. If only the deep layer is suctioned, volume decreases, but a thick, heavy layer of fat remains under the skin, making it hard for the stretched skin to contract. Superficial liposuction evenly removes fat up to the shallow layer close to the skin, making the remaining skin tissue thinner and lighter. The thinner skin contracts again and settles closely over the reduced volume, and this is the principle by which it helps improve sagging in drooping breasts.
Textbooks and papers describe the same principle.
How Textbooks and Papers Explain It
① The liposuction textbook chapter "Three-Dimensional Superficial Liposculpture for Aged and Relaxed Skin" explains that removing superficial fat allows very delicate contouring and better skin retraction. It also states that the thinner the skin, the better it retracts, and the more relaxed the skin, the thinner it must be sculpted to bring out its retractile properties, describing that in this way the skin becomes not a passive element of the surgery but an active element that wraps the form. At the same time, it stresses preserving the layer beneath the vascular network just under the skin and leaving about 3–4 mm of fat beneath the skin.
Source: Gasparotti M. Three-Dimensional Superficial Liposculpture for Aged and Relaxed Skin. In: Shiffman MA, Di Giuseppe A (eds). Liposuction: Principles and Practice. Springer, 2006. Chapter 29.
② A 1995 paper in an aesthetic plastic surgery journal reported that subdermal superficial liposuction is a method of treating the shallow fat layer to obtain better skin retraction, and that it can also be used when the skin has difficulty adapting. This paper focused mainly on the abdomen, arms, and thighs rather than the breasts, but the principle of skin retraction is the same.
Source: Gasperoni C, Salgarello M. Rationale of Subdermal Superficial Liposuction Related to the Anatomy of Subcutaneous Fat and the Superficial Fascial System. Aesthetic Plastic Surgery. 1995;19:13-20.
Micro-Liposuction — Thin and Even, With a Fine Cannula
It is difficult to suction fat near the skin thinly and evenly with a thick cannula. That is why Venus Clinic uses fine cannulas called micro cannulas. In the early days of liposuction, thick cannulas 6–10 mm in diameter were used, but once the method of injecting tumescent solution to swell the fat tissue came into use, it became possible to suction adequately even with thin cannulas. Cannulas with an outer diameter of about 2.7 mm (12G) or less are generally classified as micro cannulas, and for areas that require delicacy, such as the breasts, we use even finer cannulas of about 16–18G (outer diameter about 1.3–1.6 mm).
Many Passes With a Thin Cannula, Evenly
A thin cannula removes less fat with each pass, but its paths become denser, which makes it easier to keep the remaining fat layer at an even thickness. It is a procedure that takes much more time and care, but when used together with superficial liposuction, it helps encourage as much skin contraction as possible. The description of micro cannulas here is based on Venus Clinic's surgical materials.
Sagging Is Not "Completely" Corrected
Superficial liposuction is a method that encourages skin contraction to help improve sagging; it does not remove all of the stretched skin. The degree of skin contraction varies from person to person depending on skin elasticity and the degree of sagging. In particular, if skin elasticity has already decreased considerably before surgery, or if the skin is very stretched while little fat remains after dieting, skin contraction may not be sufficient, and some sagging or wrinkles may remain. Also, what liposuction can reduce is the fat inside the breast, so if there is a lot of glandular tissue, the reduction in volume may be smaller. For this reason, in the pre-operative consultation we look at skin elasticity, the degree of sagging, and the proportion of fat in the breast together, and explain in advance the range of results you can expect.
Results Can Change With Weight Changes
Even after liposuction, the remaining fat cells can grow larger again if you gain weight. Because the breast contains a lot of fat, its size and shape can also change if your weight changes after surgery, and age-related changes also affect breast shape. Continuing to manage your weight after surgery helps maintain the refined shape for a long time.
Advantages of Liposuction Breast Reduction for Sagging Breasts
Surgery Through Small Incisions
Because the surgery is performed by inserting a thin cannula through small incisions a few millimeters in size, no long incision lines are left around the breast or the areola. The incisions are placed in inconspicuous spots, such as the armpit crease or the fold under the breast, and most of them fade over time.
The Surrounding Areas Are Refined Together
With sagging breasts, it is common for not only the breast itself but also the accessory breast tissue toward the armpit and the volume on the side of the chest next to the breast to stand out. Liposuction can refine the breast, accessory breast, armpit, and side of the chest as one continuous line, so the boundaries with the surrounding areas look natural, and a balanced shape can be expected not only from the front but also from the side.
Recovery After Surgery
After surgery, you wear a compression garment to help the thinned skin settle back over the reduced volume. The textbook mentioned above also explains that elastic compression bandages and compression garments suited to the skin's readaptation are helpful. Swelling and bruising occur right after surgery and usually subside gradually over time.
The recovery period and care methods vary depending on the extent of surgery and each person's condition, so we give you detailed guidance at your post-operative visits while checking how you are doing.
Before-and-After Photos
The three photos below are of one patient who had liposuction breast reduction for sagging breasts at Venus Clinic, taken from the front, at an oblique angle, and from the side, and all of the post-operative photos were taken one week after surgery. Since swelling and bruising are still present at this stage, they are not the final result, and the shape will change a little more as the swelling goes down.
First Photo — Front
This is a case of breasts that stretched downward after childbirth. Before surgery, both breasts hung down long. In the photo taken one week after surgery, breast volume has decreased and the breasts, which had been hanging down, sit in a higher position. The yellow bruise visible on the lower part of the left breast is post-operative bruising in the process of fading and will disappear over time.
| Information on the Posted Liposuction Before-and-After Photos | |||
|---|---|---|---|
| - Same person | Surgery performed at Venus Clinic; same person | - Date taken | Taken around 2025; comparison at 1 week after surgery |
| - Same conditions | Edited to the same posture and size as closely as possible | - Side effects | https://en.myvenus.co.kr/should_know/38861 |
Second Photo — Oblique
This is a case of breasts that stretched downward after childbirth. In the pre-operative photo taken at an angle, the sagging of the breasts was clearly visible. One week after surgery, breast volume has decreased and the breasts sit in a higher position. The yellow bruise on the lower part of the left breast can also be seen in this photo; it is in the process of fading as she recovers.
| Information on the Posted Liposuction Before-and-After Photos | |||
|---|---|---|---|
| - Same person | Surgery performed at Venus Clinic; same person | - Date taken | Taken around 2025; comparison at 1 week after surgery |
| - Same conditions | Edited to the same posture and size as closely as possible | - Side effects | https://en.myvenus.co.kr/should_know/38861 |
Third Photo — Side
This is a case of breasts that stretched downward after childbirth. In the pre-operative photo taken from the side, the lower part of the breast hung downward. One week after surgery, the volume that had been hanging down has decreased and the lower line of the breast has moved up. Since swelling is still present at this stage, the shape will change a little more as she recovers.
| Information on the Posted Liposuction Before-and-After Photos | |||
|---|---|---|---|
| - Same person | Surgery performed at Venus Clinic; same person | - Date taken | Taken around 2025; comparison at 1 week after surgery |
| - Same conditions | Edited to the same posture and size as closely as possible | - Side effects | https://en.myvenus.co.kr/should_know/38861 |
In Closing
Breasts that have become smaller and saggy after childbirth or dieting are in a state where the volume has decreased but the skin remains. What matters here is not removing a lot of fat but leaving the fat layer under the skin evenly and well so that the skin can contract again. At Venus Clinic, we perform superficial liposuction and micro-liposuction together to encourage skin contraction, and we plan surgery with the aim of helping improve sagging.
References: Volume-Up Liposuction for Breast Reduction Complications and Side Effects of Liposuction
Dr. Hakjun Kim, Director, Venus Clinic
