Breast Implants - Options for Very Small Slightly Saggy Breasts

YOur posted photos show flattened out breasts with nipples above the level of the under breast skin folds. There does not appear to be any excess skin so it is unlikely that you would need any lifting procedure. Since the upper half of the breasts has very little tissue an under the muscle position is probably your best bet even is you use silicone instead of saline. The breasts are not symmetric in shape so perfect symmetry after surgery is not possible.

You should pick a breast implant size by trying out different sized implant samples under your bra. The surgeon would then pick the implant base diameter based on your breast measurements.

You currently have no cleavage and that cannot be created by breast implants. Most importantly your nipples point off to the sides, right more so than left. You will need nipple repositioning at the time of surgery because if you just put the implants in the nipples will diverge even more from the midline. This can usually be accomplished by removing a small crescent of skin beside the areola in the direction you want to move the nipple. Since you would need that it is probably best to place the implants through that skin incision. You can see an example case in the referenced web page.

I hope you realize that this format of posting questions and receiving answers lacks the face to face direct communication required for you to make an informed decision regarding your surgery.

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.

Although a in-person consultation is always necessary before making any strong recommendations, it appears as though a silicone implant (exact size to be determined) would best suit you.  This would provide the most natural look and feel given that your breast skin and substance has been thinned out from the three pregnancies.  Best of luck...RAS

It's not unusual for plastic surgeons to encounter patients who have breast hypoplasia associated with mild breast sag. These patients want larger breasts, but don't want the scarring that's frequently seen with breast lift surgery.Under these circumstances, dual plane breast augmentation offers significant advantages. The procedure creates a pocket beneath the pectoralis muscle as well as a separation between the muscle and the overlying breast tissue. This results in the implant having muscle coverage superiorly and breast tissue covering the implant inferiorly.This configuration allows the breast tissue to cover the implants in a more natural way. It avoids the need for a breast lift and avoids a snoop dog deformity. In addition, patients continue to have the advantages of sub muscular implant placement including a decreased risk of capsular contracture.It's important to realize that everyone's idea of a C cup is different. For this reason, we utilize the 3D Vectra imaging system and external sizers before surgery. We find that this approach minimizes confusion regarding implant size.If you're considering breast augmentation and have mild breast sag, you may be an excellent candidate for this procedure. Under these circumstances, it's important to consult a board certified plastic surgeon.

You may be able to lift your breasts with implants of a firmer texture and narrower base width, however the lift would probably not be able to achieve as perky a contour as you'd like. You don't have to get a lift, but you should understand that your results may be like a "ball in a sock". However, please see an experienced board certified plastic surgeon for a physical examination. Best of luck.

Based on your photos, I would recommend a breast augmentation using a silicone implant in the dual-plane position using an infra-mammary approach. Seek a board certified plastic surgeon for recommendations.