Columbia Breast Lift doctors

What you describe are common changes to the female breast that you rightly identify are due to pregnancy and aging, similar changes can also be seen after weight loss. These anatomic changes can only be addressed by surgery.   The decisions that  you and your board certified surgeon need to make should include the incision pattern and whether to use an implant.  It has been my experience that patients with moderate to severe changes benefit the most from a vertical(lollipop incision) augmentation mastopexy.

Although your photo is appreciated, it does not allow a complete analysis.  In general, post partum changes can give the breast a deflated appearance with a nipple areolar complex below the fold.  Given your body habitus, you would likely benefit from a vertical (lollipop incision) augmentation-mastopexy.  This involves both repositioning the nipple areolar complex and the breast higher on the chest wall and using an implant to increase volume and enhance shape.  This would likely enhance your overall proportion and correct the post partum changes you wish to improve.

The idea of a scarless surgery is an attractive one.  In reality, any time a surgeon makes an incision on the skin, we, as humans, all heal by scar.  It is better to think of it as minimizing the length of any scar and optimizing its position in order to obtain the best result.  Depending on the degree of ptosis (sagging) and the size of the nipple areolar complex, you may wish to consider a vertical mastopexy or a periareolar mastopexy, ometimes known as a lollipop and donut incision respectively.  I would recommend a consultation with a board certified plastic surgeon in order to better explore your options.  If you are uncertain about the placement and length of the incisions, you may ask the surgeon to mark his operative plan.  I have found this to be a helpful teaching tool which enhances patient understanding.  Best Wishes.