If your desire is to lift your breasts and not be reliant on a push-up bra, then your only real option is a breast lift (mastopexy) with or without breast implants. Every woman experiences changes after pregnancy and, although it varies from patient to patient, the changes usually involve loss of breast volume and some degree of droopiness because of weakening of the breast supporting ligaments.
If you are happy with the size of your breast, a breast lift is a great option. The incisions vary, but usually involve an incision around the areola and a vertical incision below the areola (lollipop incision). Sometimes, an incision is needed in the fold at the base of the breast. This allows your surgeon to reshape and resuspend your breast tissue and to raise the nipple and areola to an appropriate position. The ultimate shape of the breast is much improved from the preoperative appearance, but the operation isn't perfect for maintaining long-term upper pole fullness.
If you wish to add volume to the breasts, or have hollowing of the upper portion of your breasts, you may wish to consider adding a breast implant. This can be placed through the same incisions used to perform the lift. Sometimes, adding an implant allows the surgeon to use fewer and shorter incisions.
Your best bet is consultation with a board-certified plastic surgeon for a thorough and comprehensive evaluation. Best of luck.
