Breast development is a central aspect of femininity and health, involving complex biological processes influenced by genetics, hormones, and environmental factors. Understanding these processes can help in making decisions about undergoing surgery and when to have breast surgery.

When Do Breasts Stop Growing?

Breast development typically begins between the ages of 8 and 13 and can continue into the early twenties. The timing of breast growth cessation varies from person to person, usually ending by the age of 17 to 20. However, breasts can continue to change due to weight fluctuations, hormonal changes, or pregnancy.

Stages of Breast Development

Breast development, clinically referred to as thelarche, occurs in five distinct stages as defined by the Tanner Scale:

1. Prepubertal Stage (Tanner Stage I): No glandular tissue; the areola follows the skin contours of the chest.
2. Breast Bud Stage (Tanner Stage II): Small mound of breast and nipple develops; the areola begins to widen.
3. Further Enlargement (Tanner Stage III): Breast and areola enlarge; no contour separation between them.
4. Areola and Nipple Projection (Tanner Stage IV): The areola and nipple form a secondary mound over the breast.
5. Mature Adult Breast (Tanner Stage V): The breast becomes rounded and only the nipple is raised.

Changes in Breasts with Ageing

As a woman ages, her breasts undergo several changes, often influenced by factors like gravity, loss of skin elasticity, hormonal shifts, and involution (the shrinkage of glandular tissue). Common changes include:

• Sagging (Ptosis): Breasts lose their elasticity and droop. It is invariable that the breasts will droop at some point. The most common causes of sagging are after weight loss and pregnancy. It is very common for weight loss to result in sagging of the breasts since the fat in the breasts reduces whilst the skin envelope remains the same. Patients that have sagging breasts are likely to need an uplift or mastopexy procedure.
• Size changes: Post-menopausal women may notice a decrease in breast size as oestrogen levels decline. Some women may gain weight with age resulting in more fat in the breasts making them bigger in size.
• Texture changes: Breasts may feel softer and less dense, which can affect mammographic sensitivity. The ageing process may result in changes to the glandular volume of the breasts which makes them less dense.

Factors Determining Breast Size

Breast size is primarily determined by:

• Genetics: The inherited traits from parents play a crucial role. This is likely to be the most significant factor in determining your breast size. When we see patients coming for breast enlargement surgery they often have mothers or sisters that have also had boob jobs.
• Hormonal levels: Oestrogen and progesterone levels affect the size and volume of breast tissue. It is very common to notice a loss of size after stopping the oral contraceptive pill since the hormonal levels change.
• Body weight: Adipose tissue or fat in breasts determines part of their size; thus, overall body fat can impact breast size. Patients that have lost weight will often notice that the breasts feel more empty and loss volume from the top of the chest. This may result in the bra cup not filling like it used to.

Options for Small Breasts

For individuals seeking enhancement of small breasts, there are a few options which include:

• Breast Augmentation Surgery: Using breast implants or fat grafting to increase size and improve shape. The use of implants gives a more predictable volume increase whilst the fat transfer may often require a number of procedures with less predictable results.
• Hormonal Therapy: Sometimes used, albeit cautiously, to influence breast tissue growth. This is not a routine way of increasing breast size and is not normally recommended.
• External Prostheses and Padded Bras: Non-surgical options that alter the appearance but not the actual size of breasts. There are many types of bras that can enhance the look of the breasts by providing support.

Options for Large Breasts

For those experiencing discomfort or aesthetic concerns with large breasts or macromastia, options include:

• Breast Reduction Surgery: Removal of breast tissue and skin to achieve a breast size in proportion with the body. Breast reduction involves removing some of the breast volume and skin from the breast to reduce the size and lift the breasts. The size of the areolar is also reduced during this procedure.
• Supportive Garments: Properly fitted bras can provide support and alleviate discomfort.

Does Exercise Help Develop Breasts?

Exercise does not directly increase breast size since breasts do not contain muscles. However, exercises targeting the pectoral area beneath the breasts can improve posture. Exercise does not help lift saggy breasts despite many people believing this.

Changes with Pregnancy

During pregnancy, hormonal changes prepare the breasts for lactation or milk production, leading to:

• Size Increase: Engorgement with blood, fat tissue, and retained fluids can occur.
• Areola Changes: Darkening and enlargement of the areola.
• Vein Visibility: Increased blood flow may make veins more apparent.

Breastfeeding and Breast Size

Breastfeeding can lead to changes in breast size and shape over time. Initially, breasts may enlarge due to milk production. Post-weaning, some women may find their breasts smaller or sagging compared to pre-pregnancy, as part of normal involution.

Understanding these facets of breast development and change provides a foundation for addressing cosmetic or medical concerns related to breast health. We recommend booking a consultation with Mr. Nassab, plastic surgeon in Manchester and Cheshire, to discuss your concerns with breast size whether small or large. He will provide bespoke solutions to help you address your concerns and expectations.

Ask the Expert

Mr. Reza Nassab

Mr. Reza Nassab MBChB, MSc, MBA, FRCS (Plast) is well established consultant plastic surgeon with a specialist interest in the field of cosmetic surgery. Mr. Nassab performs a wide range of procedures for the face, breast, body and skin. He is one of the most sought after cosmetic surgeons in the North West, Cheshire and UK. He has numerous patients from around the world from countries such as Dubai, Ireland, Finland, France and Spain.

Mr. Nassab offers patients a bespoke holistic approach. His consultation identifies your expectations and desires. He will discuss options specific to your needs to help achieve realistic goals. His philosophy is that individual patient is unique in their goals and anatomy therefore each treatment plan has to be tailored to that individual.

Mr. Nassab has become the one of the go to plastic surgeons by celebrities and influencers. He has been featured on the TV show The Real Housewives of Cheshire performing procedures such as the Mummy Makeover and Eyelid Lift. He has also featured on the ITV show Olivia Attwood’s Price of Perfection. He is well known for his breast augmentation surgery and a number of his celebrity patients have shared their stories in the press and media.