Breast Implant Options for Saggy Breasts Without Breast Lift?

Hi there-
I wish I could tell you what you want to hear... but I can't...
Judging from your photo, there is no technique or implant that would give you a pleasing, round, and perky shape without a breast lift.
Variables such as the implant type and fill volume are going to affect the overall appearance of size you achieve, but will have much less of an affect on the shape and position of your breasts than the amount and quality of skin present.
Given your current, significant degree of ptosis (sagging), and the position of your nipples, as well as the position of your breasts, you are unlikely to achieve a pleasing outcome without a breast lift. And here's the thing... if you search hard enough for someone willing to do the operation you are shopping for, you will find someone- but then when your breasts don't have the shape you wanted, having it corrected will cost even more of your valuable time and money- if correction is even possible at that point.
I think you are much better off looking for a surgeon certified by The American Board of Plastic Surgery who can show you photos of his/her breast lifts and implants that would make you happy in the first place and with only one surgery... Are the scars necessary? Yes they are... but it is not necessary that the scars be a problem fro you. There are many things that can be done to modulate scar maturation so that the scars fade to a very inconspicuous and thin line.

If you have a clear understanding of what the outcome will be after an implant alone, and you absolutely do not want a lift, then your breast shape can be improved and the size made larger with an implant alone. I would use a high profile implant to maximize your lift.

While an implant can allow patients with a small amount of sagging to avoid a breast lift, unfortunately you won't be able to achieve a satisfactory result without a lift. An implant alone, no matter the size or how it is placed, will not give you a result you will be happy with. Best of luck. 

Thank you for your question. There are some women who will benefit from adding a breast lift to a breast augmentation. In general, if your nipple is located at or above the crease below your breast then a lift is typically not needed. In addition to nipple position, measurements are also used to determine when to add a lift. Breast sagging is a spectrum and women with mild/moderate sagging can sometimes go either way. In this situation, I typically recommend breast augmentation as an initial procedure, waiting six months, and then only performing a breast lift if it is truly needed. When considering breast augmentation make sure you find a board certified plastic surgeon who will take the time to answer all of your questions and explain all of your options, so that you can decide which procedures are right for you. 

Thank you for your photo. The photo shows that your nipple and areola are below the breast fold where the wire of your bra would be. This is an easy well to tell whether you need a breast lift. When the nipple is that low, placing even large implants will result in a large, saggy breast. You should reconsider having a breast lift with implants. Good Luck!

Although many women understandably want to minimize scars (as do we plastic surgeons). if you have a certain amount of droopiness (grade 2 or 3 ptosis with the nipple just below or lower beneath your breast fold) then a lift is indicated. For women that are full breasted enough, then a lift alone may be sufficient albeit with a slight reduction in volume/cup size/If you are looking for added fullness that the best choice is a combination of a lift and implants. Based on your photos likely you will need a vertical mastopexy ("lollipop lift") and an implant in the range of 400+ CC. A higher profile implant is best when performing a lift especially if you are looking for a D/DD result.