Borderline Needing a Lift. Are Subglandular Silicone Implants Right for my Ptosis? (photo)

I hear what you are saying, but like many of my colleagues feel that large subglandular implants will eventually sag due to the implant weight and skin laxity.  Subpectoral placement tends to be better for upper pole fullness and may be combined with a periareolar mastopexy if necessary.  For narrow breast width, I frequently use moderate plus implants, rarely HP.  Yes, after pregnancy a breast lift may be beneficial. 

Thank you for the photographs and for your question.  You have a very slight degree of droop.  In your situation I generally recommend placing the implants, allowing them to settle and consider a lift or tightening of the breast only if necessary after about six months.  While implants above the muscle would give more lift I generally favor implants below the muscle because they tend to look more natural and mammography is better. In someone like yourself I favor the wait and see approach because once you have the scars  associated with a lift you really can't take them back.  If you do the implant first you have burned no bridges.  While a 450 implant is a generous size it will give a lot of elevation of the breast. In my experience most people with your starting situation will generally do fine with just the implant, particularly a high profile implant.

As long as you and your surgeon are on the same page and are comfortable with a possible future lift I would take the option that starts out with the least scarring.

Best of luck.