1. Anatomy
2. Composition
3. Breast Development
4. Stages Of Breast Development
5. Breast Size, Appearance and Change Over Time
6. Effect Of Hormones
7. Growth Mechanism
8. Factors Effecting The Breast
9. Breast Sagging
10. Levels Of Sagging
11. Shapes Of Breast
12. Breast Facts
13. Myths About Breast

BREAST ANATOMY

Because the breast is made up of tissues with different textures, it may not have a smooth surface and often feels lumpy. This irregularity is especially noticeable when a woman is thin and has little breast fat to soften the contours; it becomes less obvious after menopause, when the cyclic changes and endocrine stimulation of the breast have ceased and the glandular tissue softens. Estrogen supplements after menopause can cause continued lumpiness. The breast glands drain into a collecting system of ducts that go to the base of the nipple. The ducts then extend through the nipple and open on its outer surface. In addition to serving as a channel for milk, these ducts are often the source of breast problems

The ducts end in the nipple, (which projects from the surface of the breast), and are a conduit for the milk secreted by the glands and suckled by a baby during breast-feeding. There is considerable variation in women's nipples. In some, the nipple is constantly erect; in others, it only becomes erect when stimulated by cold, physical contact or sexual activity. Still other women have inverted nipples.

Surrounding the nipple is a slightly raised circle of pigmented skin called the areola. The nipple and areola contain specialized muscle fibers that make the nipple erect and give the areola its firm texture. The areola also contains Montgomery's glands, which may appear as small, raised lumps on the surface of the areola. These glands lubricate the areola and are not symptoms of an abnormal condition. 

Beneath the breast is a large muscle, the pectoralis major, which assists in arm movement; the breast rests on this muscle. Originating on the chest wall, the pectoralis major extends from deep under the breast to attach to the upper arm. It also helps form the axillary fold, created where the arm and chest wall meet. The axilla (armpit) is the depression behind this fold.

Each woman's breasts are shaped differently. Individual breast appearance is influenced by the volume of a woman's breast tissue and fat, her age, a history of previous pregnancies and lactation, her heredity, the quality and elasticity of her breast skin and the influence of hormones.  

 Breast consists of:

1. Cooper's Ligament: a strong ligamentous band extending upward and backward from the base of Gimbernat's ligament along the iliopectineal line to which it is attached -- called also ligament of Cooper.
2. pectoralis major: a larger chest muscle that arises from the clavicle, the sternum, the cartilages of most or all of the ribs, and the aponeurosis of the external oblique muscle and is inserted by a strong flat tendon into the posterior bicipital ridge of the humerus.
3. pectoralis minor: a smaller chest muscle that lies beneath the larger, arises from the third, fourth, and fifth ribs, and is inserted by a flat tendon into the coracoid process of the scapula.
4. connective tissue: a tissue of mesodermal origin rich in intercellular substance or interlacing processes with little tendency for the cells to come together in sheets or masses ; specifically : connective tissue of stellate or spindle-shaped cells with interlacing processes that pervades, supports, and binds together other tissues and forms ligaments and tendons.
5. blood vessels: any of the vessels through which blood circulates in the body.
6. ribs: any of the paired curved bony or partly cartilaginous rods that stiffen the lateral walls of the body of most vertebrates and protect the viscera, that occur in mammals exclusively or almost exclusively in the thoracic region, and that in humans normally include 12 pairs of which all are articulated with the spinal column at the dorsal end and the first 10 are connected also at the ventral end with the sternum by costal cartilages.
7. subcutaneous fat: fat cells being, living, used, or made under the skin.
8. infra-mammary crease: infra- meaning below, mammary meaning breast. The fold or crease under the breast where the breast lobe meets the torso.
9. breast fat: fatty tissue found above the glandular tissue of the breast.  The breast is mostly  made up of lobules, milk ducts, fat, and glandular tissue.
10. ducts: a bodily tube or vessel especially when carrying the secretion of a gland, specifically breast milk. esp. lactiferous ducts, milk ducts
11. glandular tissue: of, relating to, or involving glands, gland cells, or their products; specifically breast milk production. esp. lobules
12. nipple: the protuberance of a mammary gland upon which in the female the lactiferous ducts open and from which milk is drawn
13. lobules: The glandular part of the breast where milk is produced
14. breast envelope: the skin which surrounds the structure of the breast.

 BREAST COMPOSITION
 

The breast is composed of:

• milk glands (lobules) that produce milk
• ducts that transport milk from the milk glands (lobules) to the nipple
• nipple
• areola (pink or brown pigmented region surrounding the nipple)
• connective (fibrous) tissue that surrounds the lobules and ducts
• fat

BREAST DEVELOPMENT                              

Though breast growth is not visible until puberty, breast development begins very early in the embryo and can be discerned within just a few weeks of conception. Interestingly, the earliest stages are identical in male and female fetuses, so many men could develop fully functioning breasts given the right hormonal conditions         

After birth the breast has only two phases of development; the first at puberty with the outpouring of the hormones oestrogen and progesterone; the second during pregnancy and lactation, when the milk-producing lobules become larger                                              

If puberty is stunted or if a woman remains childless, her breasts will not fully develop. The first stage of breast development begins in the embryo at about six weeks, with a thickening in the skin called the mammary ridge or milk line                           

By the time the fetus is six months old, this extends from the armpit to the groin, but it soon dies back, leaving two breast buds on the upper half oft he chest. Occasionally, rudimentary mammary glands develop along the milk line forming additional nipples or breasts that sometimes persist into adult life. More rarely, the two breast buds fade away with the rest of the milk line, so that the nipples are absent from birth                 

Because the initial development of the milk line is the same in male and female fetuses, this development can appear in the male and the female.
 
When a female fetus is about six months old, 15 - 20 solid columns of cells grow inward from each breast bud. Each column becomes a separate "sweat" or exocrine gland. With it’s own separate duct leading to the nipple                                          

By the eighth month of fetal development, these columns of cells have become hollow so that, by birth, a nipple and a rudimentary milk-duct system have formed. No further development takes place until puberty                                      

The first external signs of breast development appear at the age of 10 or 11 - though it can be as late as 14 years. The ovaries start to secrete estrogen leading to an accumulation of fat in the connective tissue that causes the breast to enlarge. The duct system also begins to develop, but only to the point of forming cellular knobs at the end of the ducts                                                                                    

As far as we know the mechanism that secretes milk doesn’t develop until pregnancy. Although the breast may appear fully grown within a few years of puberty, strictly speaking, their development is not complete until they have fulfilled their biological function - that is, until the woman carries a pregnancy to term and breast-feeds her baby, when they will undergo further changes                                          


MATURITY OF THE BREASTS                                                     

Once a young woman reaches puberty, and ovulation and the menstrual cycle begins, the breasts start to mature, forming real secretory glands at the ends of the milk ducts. Initially these glands are very primitive and may consist of only one or two layers of cells surrounded by a base membrane.

Between this membrane and the glandular cells are cells of another type, called myo-epithelial cells, these cells are the ones that contract and squeeze milk from the gland if pregnancy occurs and milk production takes place .

With further growth, the lobes of the glands become separated from one another by dense connective tissue and fat deposits. This tissue is easily stretched. This is where the natural enlargement formula comes in and allows the enlargement that normally occurs during pregnancy when the glandular elements swell and grow      

The duct system grows considerably after conception and many more glands and lobules are formed. This causes the breast to increase in size as it matures to fulfill its role of providing food for the baby                                                         

FEMALE CHANGES        

Most women notice that just before menstruation their breasts enlarge and their nipples become sensitive and even painful. The texture of the breasts change and they become rather lumpy, with small discrete swellings that resemble orange pips in both texture and size. These lumps are glands in the breast which enlarge in preparation for pregnancy.

If pregnancy doesn’t occur, breasts return to their normal size and the glands become imperceptible to touch within a few days, ready for re-growth the next month. These changes in the breast are only one part of many changes that occur in the female body as the result of the monthly ebb and flow of the female hormones estrogen and progesterone .

AGING OF THE BREASTS    

As we get older, our breasts tend to sag and flatten; the larger the breasts, the more they sag. With the menopause there is a reduction in stimulation by the hormone oestrogen to all tissues of the body, including breast tissue; this results in a reduction in the glandular tissue of the breasts. So they loose their earlier fullness.

Regular exercise would have however prevented or slowed down the ageing process. Much of the connective tissue in the breast is composed of a fibrous protein called collagen, which needs oestrogen to keep it healthy. Without oestrogen, it becomes dehydrated and inelastic. Once the collagen has lost its shape and stretchability it "was" believed that it could not return to its former state or condition

STAGES - BREAST DEVELOPMENT

Human breast tissue begins to develop in the sixth week of fetal life. Breast tissue initially develops along the lines of the armpits and extends to the groin (this is called the milk ridge). By the ninth week of fetal life, it regresses (goes back) to the chest area, leaving two breast buds on the upper half of the chest. In females, columns of cells grow inward from each breast bud, becoming separate sweat glands with ducts leading to the nipple. Both male and female infants have very small breasts and actually experience some nipple discharge during the first few days after birth.

Female breasts do not begin growing until puberty—the period in life when the body undergoes a variety of changes to prepare for reproduction. Puberty usually begins for women around age 10 or 11. After pubic hair begins to grow, the breasts will begin responding to hormonal changes in the body. Specifically, the production of two hormones, estrogen and progesterone, signal the development of the glandular breast tissue.. During this time, fat and fibrous breast tissue becomes more elastic. The breast ducts begin to grow and this growth continues until menstruation begins (typically one to two years after breast development has begun). Menstruation prepares the breasts and ovaries for potential pregnancy.

 FIVE STAGES OF BREAST DEVELOPMENT

 BREAST SIZE, APPEARANCE, AND CHANGES OVER TIME

The size and shape of women’s breasts varies considerably. Some women have a large amount of breast tissue, and therefore, have large breasts. Other women have a smaller amount of tissue with little breast fat.

Factors that may influence a woman’s breast size include:

• Volume of breast tissue
• Family history
• Age
• Weight loss or gain
• History of pregnancies and lactation
• Thickness and elasticity of the breast skin
• Degree of hormonal influences on the breast (particularly estrogen and progesterone)
• Menopause

A woman’s breasts are rarely balanced (symmetrical). Usually, one breast is slightly larger or smaller, higher or lower, or shaped differently than the other. The size and characteristics of the nipple also vary greater from one woman to another. In some women, the nipples are constantly erect. In others, they will only become erect when stimulated by cold or touch. Some women also have inverted (turned in) nipples. Inverted nipples are not a cause for concern unless the condition is a new change. Since there are hair follicles around the nipple, hair on the breast is not uncommon.

The nipple can be flat, round, or cylindrical in shape. The color of the nipple is determined by the thinness and pigmentation of its skin. The nipple and areola (pigmented region surrounding the nipple) contain specialized muscle fibers that respond to stimulation to make the nipple erect. The areola also houses the Montgomery’s gland that may appear as tiny, raised bumps on the surface of the areola. The Montgomery’s gland helps lubricate the areola. When the nipple is stimulated, the muscle fibers will contract, the areola will pucker, and the nipples become hard.

Breast shape and appearance undergo a number of changes as a woman ages. In young women, the breast skin stretches and expands as the breasts grow, creating a rounded appearance. Young women tend to have denser breasts (more glandular tissue) than older women.

During each menstrual cycle, breast tissue tends to swell from changes in the body’s levels of estrogen and progesterone. The milk glands and ducts enlarge, and in turn, the breasts retain water. During menstruation, breasts may temporarily feel swollen, painful, tender, or lumpy.

THE EFFECTS OF HORMONES ON BREAST TISSUE
 

Breast shape and appearance change as a woman ages. In the young woman the breast skin is stretched and expanded by the developing breasts. The breast in the adolescent is usually hemispherical, rounded and equally full in all areas. As a woman gets older, the topside of the breast tissue settles to a lower position, the skin stretches and the shape of the breast changes. After menopause, with the decrease of hormonal activity, the composition of the breast changes; the amount of glandular tissue decreases and fat and ductal tissue become the predominant components of the breast. Reduction in glandular volume can result in further looseness of the breast skin.

BREAST ENHANCEMENT : GROWTH MECHANISM

Scientists have proven that stimulating the estrogen receptors in the breast with estrogen or estrogen like substance (phytoestrogens) can actually increase the size of the female breast as much as 150%.

SUMMERY

The estrogen initiate growth of the breast and are responsible for the characteristic external appearance of the mature female breast.

In females where the ovaries don't produce sufficient amounts of estrogen and progesterone under developed breasts may occur. As females age, the ovaries slowly begin to produce less hormones, resulting in sagging smaller breasts. Scientific evidence shows that additional estrogen and progesterone may enhance breast growth.

Phytohormones are estrogen like compound. Phyto-estrogens can share some of the same biological activities with oestrogens produced in the body. Although Phyto-estrogens are much weaker than the body’s own naturally occurring (or endogenous) estrogens, estrogen-like effects are apparent after the consumption of Phyto-estrogens in many, if not all, of the oestrogen-receptive tissues in the body.

FACTORS THAT AFFECT THE BREAST Although the breasts of non-pregnant women are generally considered inactive, they undergo cyclic changes associated with normal ovulation. Many women experience a premenstrual increase in breast size and density. Many women also feel breast tenderness in relation to these changes. This slight engorgement is probably due to tissue edema (holding water in the tissue). Older women who have fibrotic lumps may experience an increase in pain, usually along the perimeter of the breast mass. The volume and density changes are thought to be resultant of the changing levels of estrogens and progesterone during the menstrual cycle. Hormone therapy, such as birth contraceptives, can also influence breast density. A constant inrush of estrogens and progestins can simulate premenstrual breast changes, often making the breasts tender. During menopause the changes in gonadotropins, estrogens and progesterone induce changes in both glandular and ductal components. Without hormone replacement therapy, the number and size of the glandular elements decrease and the volume of the breast becomes smaller. Likewise, there is a loss of contour due to the decrease in structure. During pregnancy, the numerous changes in the breast induce gradual increases in weight and size as it produces and stores milk. The lactating breast is continually changing density, and the sensitive nipple is extremely vulnerable to chaffing by fabric rubbing. Therefore, pregnant and lactating women are highly encouraged to wear appropriate supportive bras while participating in physical activities. As we have seen, the lack of internal anatomical support of the breast structures requires some type of external support. Excessive movement of the breasts during physical exercise may increase this need for some women because of the structural changes during pregnancy and menstruation BREAST SAGGING (PTOSIS)        Most women’s breasts lose their perk with age and extremely large-breasted women will be affected earlier and to a certain degree. But the reasons aren’t related to ligaments or even strictly dependent on breast size. Much more important are inherited characteristics such as skin elasticity and breast density which reflects the ratio of lightweight fat to heavier glands.   There is the tendency for older women to show sagging of the breasts. The sagging is caused by partial deterioration of the glandular tissues that produce firmness of the breasts and some stretching of the tissues connecting the breasts to their muscles. Measures may be taken earlier in life that may prevent, or at least reduce, sagging later in life. They include wearing supportive brassieres during pregnancy, breast feeding, and exercising. Breast sagging occurs for several different reasons - multiple pregnancies, breast feeding, rapid weight loss, genetics, gravity and age. Just as all body tissues are susceptible to the effects of gravity over time, the breast, because it is an external organ and not protected from external forces, also undergoes changes over time. The connective tissues supporting the breast are always under constant stretch due to the effects of gravity on the weight of the breast, this effect eventually causes the relaxation of these supporting ligaments creating the sagging effect. Breast feeding is another contributor to breast sagging because of the expansion and contraction of the breast tissue over months of breast feeding eventually results in drooping breast changes in susceptible women. Other women may be prone to ptosis because of changes in weight, genetics or multiple pregnancies. Another reason for breasts sagging is the lack of the hormone estrogen, which occurs at menopause. This reduction in estrogen affects all the tissues of the body, including breast tissue, and results in a reduction in size and fullness. The milk secretion process is also halted by this time. Much of the connective tissue in the breast is composed of a fibrous protein called collagen, which needs estrogen to keep it healthy. Without estrogen, it becomes dehydrated and loses it's elasticity. Both during pregnancy and as you reach menopause - make breasts sag even more. During pregnancy, the hormones estrogen and progesterone, which are secreted by the ovaries and the placenta, stimulate development of the 15 to 20 lobes of milk-secreting glands embedded in the breast's fatty tissue. These changes are permanent. And although the glands may be empty after they're no longer needed to produce milk, they will still add bulk and firmness to the breast.  Once menopause arrives, however, the drop in estrogen and progesterone signal the breast that its milk ducts and lobes can retire. As a result, the breasts shrinks, add fat and begins to sag over and above the demands of gravity. Fortunately there are three ways to prevent, and sometimes reverse, both saggy and stretch marks breasts. Premature sagging occurs as a result of stretching the Cooper's ligaments that help suspend and support the breast. Breast ptosis can result from a loosening of the skin and suspensory ligaments. Gravity and weight of breasts take their toll over time. Ptosis can also come from a reduction in the volume of breast tissue. This can occur after pregnancy and weight loss                                                     . One of the reasons for sagging breasts is age!  As we age, our skin ages too.  It does not hold things up as well as it did when we were young, becasue it has lost some of its elasticity. The older we get the less elastic our skin becomes.  Thats why so many older women have sagging breasts.  If you are a young woman with breasts that are sagging, it may be for several other reasons. If you are not getting enough support from your bra or not wearing a bra at all, your breasts can start to sag due to lack of support.  This is especially true for larger breasted women, and women who may be participating in sports without the proper sports bra.  The third reason for the onset of sagging breasts in some younger women is change in overall breast size after having a baby.  A woman's breasts generally become larger and engorged with milk in preparation for breastfeeding.  Once breastfeeding is over, her breasts may not snap back. As we age, after pregnancy (or exposure to breast growth due to hormones) or weight gain then loss, we experience atrophy of the breast tissue and it's envelope.  From pregnancy or hormone-induced gain then loss -- this loss is called involution.  From weight gain, then loss -- this is from the body losing the filling and fat which it had prior to the weight loss.  Aging is merciless and we start losing collagen and elastin and the breast envelope begins to thin, weaken and eventually - becomes ptotic (saggy). After our breasts enlarge due to pregnancy they usually shrink postpartumly.  Other changes result from having breastfed, estrogen and progesterone supplementation in the form or shots, implants or medications, hormonal disorders, menopause and lastly age.  As we age our skin thins, we lose breast volume due to the shrinking of our lobules due to a decrease in hormones.  We also lose body fat in areas where we want it, and seem to somehow selectively gain it where we do not.  DIFFERENT LEVELS OF SAGGING There are certainly varying degrees of ptosis which only need certain smaller lifts for correction and other cases which need a full lifting. Following are the most commonly described ptotic grades to help you better determine what you may need.  HOW TO TELL YOUR DEGREE OF PTOSIS                                                           . Determine your mammary crease as it is directly underneath the breasts.  These two levels may be higher than one another.  You can use a ruler if you wish it.  The highest part of the ruler should be directly against the junction of the breast and ribcage.     Mild Ptosis If the central point of your nipple (not your areola) is slightly above or directly in front of the top of this ruler (your breast crease) - you may have Grade 1 ptosis.  Very mild to mild ptosis usually needs only a crescent lift.  Mild to Moderate If the central point of your nipple (not your areola) is 1 - 3 cm below the top of this ruler (your breast crease) you may have Grade 2 ptosis i.e. Mild to Moderate Ptosis . Savere Ptosis   If the central point of your nipple (including your areola) is more than 3 cm below the top of this ruler (your breast crease) you may have Grade 3 ptosis i.e. Severe Ptosis. Pseudo - ptosis Psuedo-ptosis is when your nipple is still slightly or well above your inframammary crease but it still appears droopy due to the presence of a significant, but somewhat flattened, breast lobe.  Usually persons with pseudo-ptosis have smaller areola complexes which did not stretch during the pregnancy or weight gain. Mild Ptosis, Asymmmetry Even though you pass the "tests" above you may still feel as though your breasts are too low on your chest wall or that your areolae have stretched out.  Low Breast Like said above, some women's breasts actually sit on the chest wall lower. They have no ptosis, have good volume and a proper infra-mammary crease, BUT - the entire breast complex is rather low on the torso.    SHAPES OF BREAST This is the perfect breast shape.   The "swooping" breast is actually pretty common. Some maybe be due to lack of volume but no sag - it is actually among the better of the shapes to have if you're going to get implants. The nipples point upwards which is major asset in breast augmentation surgery. Of course breast shape can be hereditary.   The ptotic, (saggy) breast with some volume is also very common. Usually after a pregnancy you will lose volume, have enlarged areolae and thinned skin due to stretching during the pregnancy. Breast feeding can affect the nipple structure as well - causing it to elongate.   The ptotic, (saggy) breast with little to no volume is very common after pregnancy, breastfeeding, weight loss and aging - or all four combined. Although many young mothers may experience this after pregnancy and breast feeding, where aging is not a factor. However it is truly dependent upon the individual. The ptotic, (saggy) breast with much volume will more than likely need a lift. This case is more common than you think. This is more of a breast anomaly than a shape. Often called "Tubular breasts" or "constricted breasts". This shape is usually due to herniation of the tissue, lobules and fat without proper containment by the connective tissue under the areolae complex. Pectus carinatum congenital chest deformity (pigeon chest) with ptosis: This isn't exactly a breast shape, per se, but rather a "deformity" or divergence of the chest. The ribs usually protrude as can the sternum. Sometimes the ribs stick out much further than the sternum causing lack of self esteem or self consciousness of the breasts.   BREAST FACTS   Breasts can start growing as early as age 10 and don't stop until your early 20's. Breasts have been overly sexualized in Western culture making them too big a part of a girls physical identity. Breasts have a biological purpose - for feeding babies. Having a baby changes ones breasts forever, and many women get larger (but much less perky) breasts after pregnancy. During puberty breasts can develop rapidly causing discomfort, sensitivity and even stretch marks . Larger breasts do not make a girl more feminine, sexier or "better". Very large breasts can cause back pain and poor posture. Bras are more than just underwear, they are necessary to keep your breasts supported and to stop injury to the breast tissue while playing sports. Breast cancer is rare in teen aged girls but it is important to get used to checking your breasts for lumps and irregularities as soon as you start having your period - this is especially important if you have a family history of breast cancer. All breasts, no matter what size and no matter what guys may say, are beautiful and amazing to the opposite sex.   MYTHS ABOUT BREASTS      1. A Woman's self confidence is based on the size of her breasts.     2. Women are unconcerned about the size of their breasts.     3. Sports bras are not really needed.     4. Large breasts indicate the woman is likely to be more interested in sex.     5. Women with small breasts are unable to breastfeed successfully.     6. All women enjoy having their breast fondled.     7. Women always have two breasts of the same size.     8. Hair on the area around the nipple indicates that the woman is abnormal.     9. Women with bigger breasts are more fertile.     10. Breastfeeding leads to sagging breasts.