Based on. Your photographs and stated goal of waist contouring, you seem to be a good candidate for contouring with liposuction of the abdomen and flanks. The amount of skin retraction you get may be variable, but with good skin quality I do not believe any skin removal would be needed. I recommend having a consultation with a board certified surgeon, and stress finding one who understands your goals and will discuss your options in detail.
I understand your concern about undergoing a more invasive procedure, such as a breast lift (since you have SLE). An implant is not likely to address your breast shape and nipple position very well. If you are happy with your size, then a lift without an implant could help decrease areolar size, reposition the nipple, and get rid of extra skin. If you would like to be bigger, then a lift with implants may be needed. I recommend visiting with a board-certified plastic surgeon to get a full exam and medical history to help guide your decision process.
