Can I achieve upper pole fullness without a lift? (photos)

It's a little challenging to tell from these photos alone. By the appearance, you can certainly achieve upper pole fullness without a lift, but because of the position of your breast, it would appear that your breast had "fallen off" the implant, hence the term "Waterfall" deformity or "Snoopy Nose" deformity. Your breast would still have the same "droop," and would not be centered over the implant. Some women don't care about that because they will wear a bra at all times. But if you're looking for youthful, perky breasts with upper pole fullness, I recommend a lift.

Because your nipples appear to be located below your breast fold, a lift is recommended if you’d like more upper pole fullness. Without one, the implants would sit rather low on your chest and their weight will most likely exacerbate the sagging more, making a lift inevitable in the future.

Thank you for sharing your question and photograph. I do think you will require a lift, which can be performed individually or as part of a reduction.