95% of my patients who have been properly selected for breast augmentation without a lift to address sagging are satisfied with the amount of lift they achieve with implants. The right implants and technique can help you address mild to moderate sagging with breast augmentation alone, by taking into account the size you'd like to be and the amount of lift you require during the pre-surgery planning process.
These three things are considered to help give you the extra lift you require to make your breasts “perkier” without mastopexy:
1) During your breast augmentation, the breast implants will be placed directly under the breast tissue and above the chest wall muscle (in the sub-mammary position).
2) The best breast implants to use for a perkier result contain silicone gel that is more cohesive, such as the Allergan Inspira Truform 2 (formerly known as Soft-Touch gel). These implants are slightly firmer to maintain their shape better, but still retain their natural feel.
3) The shape of your breast implants should have more, rather than less, projection. Breast implants with a smaller base width will make your breasts project more forward from your chest wall and body, creating a more prominent contour. “Profile” is a synonym for projection, therefore look for high profile implants.
Generally speaking, larger breast implants can also help give a better lift, sometimes raising the position of the nipple by one or two centimetres.
Please see an experienced board certified plastic surgeon to find out whether you are a suitable candidate. Best of luck.