Hi Confused,
The best option ultimately has to decided upon by you. If you really want to avoid having future surgery, your best option is to have your implants removed and to have a breast lift. Because the majority of your breasts are implant, the continued presence of implants will likely mean more surgery as you get older.
Unfortunately, removing your implants and performing a mastopexy probably will not look all that nice. Not only will your breasts return to an A cup, but the supporting ligaments of your breasts have probably been stretched out by your implants. Without implants, your breasts will likely look pretty saggy within a short amount of time after surgery.
If you want the best cosmetic result, your best option would removal of your current implants with capsule removal, conversion to silicone implants below the chest wall muscle, and a breast lift. That will give you the nicest appearance, but in no way guarantees that you won't need future surgery.
Hope this helps. Best of luck.
