Brief Answer: breast augmentation surgery Detailed Answer: Hi XXXXXXX Thanks for writing in. Sagging of breast at the age of 42 years is a part of natural aging process.As the age advances elastic tissue of the breast decreases and fat deposition increases making the breast saggy. I would also like to know- What is your weight and height ? Have you reached menopause? Do you have any other illness like diabetes or hypertension? Answer the questions to help you better. For your concern of small breasts best treatment will be breast augmentation which can be done by surgery. Breast implants can be used for increasing breast size and increasing firmness. Non surgical measure would include regular exercise of upper body to tighten pectoral muscles and to bring firmness to breast. Few breast enhancing gels are available in market but their efficacy is doubtful. You can try them to start with. I will be available for follow up. Regards Dr Sudarshan. MD

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