I am 4’11” about 120lbs and I have 36C breasts, I am debating on should I get a lift, implant or combo? (Photo)

From the photographs it looks as though breast augmentation alone may yield a very good aesthetic result. I think implants in the sub glandular position camouflage ptosis better than implants in a sub muscular position

Thank you for your question!  If does appear from your photo that you have some degree of ptosis (sagging). Because you do not want to go too much larger, I would recommend a breast lift to help you obtain a perkier appearance. Based on your height and weight, a breast lift without implants would allow for a proportionate results. At 47 years old, be sure to have an up to date mammogram completed prior to your surgery. 

If you are satisfied with your current volume, a breast lift alone will give you a nice result. Women will sometimes decrease a half cup size with a lift. You only need an implant if you want to increase your volume.

hello thank you for your question and provided information as well..Based on your photo I see that you are a good candidate for a breast lift with implant.in your case it would be ideal to use small implants to obtain a better projection.  To determine the technique, it is ideal to have a consultation with your certified plastic surgeon to see you and determine which would be the correct one for your case.

You
are an excellent candidate for The Bellesoma Method.  This will reshape your breast tissue creating
upper pole fullness without implants, elevate them higher on the chest wall and
more medial to increase your cleavage. 
Vertical scars are avoided, nipple sensation and the ability to breast
feed are maintained.  At the same time or
later, fat transfers can be performed if additional volume is desired.  This will give you the perky look you desire
without the complications of implants.Best Wishes,Gary Horndeski, M.D.

Based on your picture and your statement that you are currently a C or D cup, it would not appear that you need more volume so implants are certainly not necessary.  You do appear to be a good candidate for a breast lift procedure for a better shape to your breasts.   I would suggest that you should schedule a consultation with a board-certified plastic surgeon who can examine you in person and review your options with you.

Hello and thank you for your question.  The
best advice you can receive is from an in-person consultation.  Based on
your photographs, the best shape and contour could be achieved with an implant
and a breast lift.  A breast lift with an implant can result in a very nice shape if
good technique is used.  The size, profile, and shape of the
implant is based on your desired breast size/shape, your chest wall
measurements, and soft tissue quality.  This decision should
be based on a detailed discussion with equal input from both you
and your surgeon.   Make sure you specifically look
at before and after pictures of real patients who have had this surgery
performed by your surgeon and evaluate their results.   The most
important aspect is to find a surgeon you are comfortable with. I recommend
that you seek consultation with a qualified board-certified plastic surgeon who
can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.  FACS
Harvard-trained plastic surgeon

As long as you want breasts that sit higher on your chest and look better, a breast lift alone should suffice. However, if you really like the look of fullness in the upper pole, the addition of a moderate implant will help you achieve this.
Good luck.

Patient concerns regarding the appearance of their breasts can typically be divided in two pools: volume, ptosis (droop). The procedures to address these issues are as different as the issues themselves. However, these concerns are not mutually exclusive (some want smaller less droopy breasts and others want larger less droopy breasts).
There are two factors which can help to answer the question of which surgery will deliver the most satisfying result: mastopexy, augmentation or both. Patients must first consider the position of the NAC (nipple areolar complex i.e. the pigmented portion of the breast) as it relates to the inframammary crease. If the nipples are at or below the level of the crease the patient may benefit from a lift or mastopexy. The breast lift is designed to elevate sagging breasts to a more youthful position. It also helps to reshape and tighten the skin of the breasts. This is typically accomplished via a periareolar (around the nipple) incision with or without a vertical incision.
Mastopexy is an effective way to address sagging breast, however, the changes which accompany weight loss or pregnancy can also decrease volume of the breasts. When a woman wants the volume restored, or increased, a breast augmentation will also be needed in conjunction with mastopexy. Augmentation can help restore the volume loss which is well known to women following children. There are a number of options available to women considering augmentation ranging from size and implant type to access incision.   
A breast augmentation alone may be appropriate if ptosis is mild. If the patient is comfortable with the natural appearance of the breasts but desires them to be larger, a breast augmentation alone is the right procedure.  Augmenting significantly ptotic or sagging breasts tends to magnify the problem. In these cases, a mastopexy performed in conjunction with an augmentation is preferred.
Based upon your photo, it is difficult to say for certain whether a lift will be required. It is important to remember a lift and an augmentation are different procedures. They have differing purposes and deliver different results. Thus if you need a lift, an implant alone will not suffice.
There is a procedure for every problem. To determine which technique is right for you, consult with a board certified plastic surgeon (ABPS). Patients should discuss their concerns with their physicians in order to make an educated decision.

Thank you for sharing your question and photograph. Depending on your desired appearance, the best enhancement would be obtained through placement of both implants and a lift in the same operation.  The implant will help restore your lost breast volume, and add upper breast fullness, while the lift will help position your natural breast tissue over the new implant, while also removing excess skin and elevating your nipple and areola into a more youthful position.  Hope this helps.