A breast lift with or without an implant would be a great choice, but the ability to breast feed successfully after such a surgery is in the range of about 50-70%. This surgery also typically reduces the areola size at the same time.
Plastic surgeons are careful not to guarantee the ability to breast feed after any breast surgery, particularly since some women are never able to lactate. Studies show that after a breast reduction or breast lift, 70% of women are successful in producing breast milk. If that kind of statistic is good enough odds for you, then you can have a lift now to improve your shape and reduce the size of your areola. If losing the ability to breast feed would cause you to regret your choice for surgery , then wait until you have completed your family.
If being able to breast feed is super important to you, I advise you to wait until you are done childbearing. In most cases, cosmetic breast surgery does not interfere with breast feeding but there are no guarantees.
Also, if you have breast surgery now, it is impossible to predict how your breasts will look after another child or two. Once you are done with childbearing, your breasts will no longer be a moving target.
Based on your photos, I would recommend a breast implant combined with a breast lift. The breast lift will decrease the diamater of your areola and create a nicer breast shape. The breast implant will give you more fullness to the upper part of the breast and restore some of the volume that was lost due to the pregnancy.
Consult with an experienced plastic surgeon for a complete evaluation.
The sag and stretch post pregnancy and breast feeding can definetely be improved. The perkiness can come with a combination of placing an implant behind the breast and lifting the nipple/areola to a higher position, while reducing its size. The trade off is the breast lift scars, but these are easily overlooked with time as the improved shape and perkiness outweigh the scars.
Most augmentation lifts cut few if any breast ducts. So, breast feeding can usually still happen later.
One can also just perform a breast lift/areola reduction procedure and wait to put the implant in after you are done having children.
Best to seek ONLY IN PERSON opinions from boarded PSs in your city/state. My over the internet recommendation is a lift + implants + areolar reduction operation...
Thank you for your question. From your photographs it appears that a breast lift plus breast implants will lift the breast and and fullness and would allow for a reduction of your areola diameter.
Be aware that there is a possibility that the breast lift may interfere with her ability to nurse in future pregnancies. If this is important to you I would finish having children before considering breast lift surgery.
Thank you for the pictures.
I believe that you would make a great candidate for breast lift with implants.
Thank you for sharing your photos. You are not alone. The majority of women also experience some degree of post partum breast involution following breast feeding. Your options are two fold.
If you just want to tighten the skin envelope and reduce the areola size, then a vertical mastopexy would nicely reshape your breasts.
If you would like to add volume back to the breasts, then an augmentation with a breast lift would benefit you.
Visit a well respected Plastic Surgeon for their opinion. And, if they have Vectra 3D imaging, you can preview the above two options to see which you prefer.
Larger boiled after pregnancy is common. They can be reduced with a periareolar mastopexy. This would result in a smaller nipple which is still functional. The only way to add more volume is through an augmentation.