The choice is entirely up to you, both will work. After all saline implants have been used for year in tens of thousands of women, some of whom also had breast lifts. Women today have a choice, and after learning the trade-offs of each type of implant can make an informed decision. Both are safe and effective. Saline can leak and the deflation will usually occur rapidly, letting you know that your implant has leaked. Silicone implants do not deflate, and although some of the gel may redistribute in the pocket, these are usually "silent ruptures". Diagnosis is by routine MRI as recommended by the FDA, but ultrasound, and the new 3-D mammogram are also available to check.
The pictures shown indicate that a breast lift is necessary to get a agood aesthetic result. The trade-offs will be some scars around the areola, vertically down the front, and probably under the breast to some extent. There is also breast asymmetry which can be improved upon.
Women should know also, that when there is a lot of breast, fat and skin to cover an implant, you may not be able to tell visually or by palpation whether or not the implant is gel or saline. They get camouflaged by the thickness of the overlying soft tissue. Still saline tends to be a bit bouncy under th breast, while gel is softer.
You definitely need a lift. In your case, I would probably perform the lift first, then add implants at a second stage. The breasts need to be lifted too far to accomplish it as a single stage procedure and get a good result.
Unless using a 500 cc +++ implant I believe you will need a breast lifting operation also. But only IN PERSON evaluations are indicated..//
From your photo, breast augmentation alone will not achieve your goal of improving the breast sagging. You will need a breast lift to correct the sagging issue. You have an adequate amount of breast tissue to have a very nice result without the added cost and complexity of breast implants. The breast lift without implants may be your best option. Best wishes.
Thank you for your question and photographs. Based on your photograph you will most likely benefit from a breast lift in addition to breast implants. This will be necessary for your implants to be placed beneath the chest muscle which has many advantages over placing the implant beneath the breast. Because the nipple is sagging downward if breast implants are placed without a lift you could end up with the snoopy deformity. Please consult a board certified plastic surgeon who is experienced in these techniques.
Thank you for your question and photos.
based on your photos and desires you would benefit with BOTH a breast lift (Mastopexy) and a a breast augmentation.
I suggest you make a a appointment with a Board Certified Plastic Surgeon in your area.
Also look at his/ hers ratings.
You will benefit from a breast uplift alone. If you wish to be larger then you can have breast imp0ants along with the uplift. The combination procedure of implants with uplift results in a fair percent of secondary corrections at a year so be aware of that. Another possibility is an uplift and see how you like it. If pleased stop there. If you really want to be larger then you could add a breast augmentation at a later date. Yes this adds a little to the cost but it greatly reduces the chances of secondsary corrective surgery. My Best Dr C
I think you need a breast lift as well as implants. Your nipples are quite low. Consult with a board certified plastic surgeon in your area for a definite opinion. Ask your surgeon about the option of decreasing the size of your areolae as well if that appeals to you.
It is quite evident you will need a lift to get a more age appropriate shape and size. The size of the implant depends on how large you want to be. You could have small implant or a larger implant if fullness is important. The lift is what will give you the shape you want and can be adjusted to the size of implant you choose. I would recommend that you talk to your PS who has a lot of experience with this procedure so you can get the best result.
You will need a major lift to get a good result. You have so much natural breast tissue, why not get a lift and see how you like it. You'll probably have a good cup size without implants.