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