Advice for Breast Augmentation Redo After Pregnancy?

Hi there-
In my experience, changes that occur in the shape of a woman's breast as a result of pregnancy and/or breast feeding are not easily correctible through replacement of the implant alone, especially if you don't necessarily want to be significantly larger than your current size. Replacing your implant, even with one of a different shape or style, is only going to make you larger... subtle changes in the shape may occur, but over time, the breast shape will sag even more, because nothing was done to correct the relationship between the quality/quantity of skin present.
Re-shaping your breasts is going to be an important part of achieving the breast shape you desire. The scars can be a problem, and there is no question that a specific strategy should be adhered to when doing these procedures on African-American patients (in other words, it is not reasonable in my mind to do everything the same way you would on someone with very fair skin and expect the same outcome), but as long as this is done, the scars can be as thin and inconspicuous as in caucasian patients.
The shape of the breasts is paramount- choose an operative strategy likely to give you the shape you want. Good luck!

You may benefit from a breast lift. A #mastopexy or breast lift operation is designed to improve the shape and position of the breasts without reducing their size. It is the most suitable for #breasts which sag or droop (ptosis) as a result of development, aging, pregnancy, breast-feeding and weight loss . Some patients will experience better results to restore superior fullness if an #implant is used at the time of mastopexy; better known as #AugmentationMastopexy.
With both implant types there are choices when it comes to size, shape, and profile. The criteria best to suit you will be discussed in full detail at your breast augmentation consultation. 
Altogether, the surgery will create an elevated, more youthful breast contour. Also, the nipple and areolae of the desired size and correct heightmay also be addressed. I prefer to use a #shortscar technique, #LollipopScar or #DonutLift” rather than the majority of surgeons in the United States that use an anchor pattern lift which involve more significant scarring.The best method and #technique for your #procedures will be discussed in greater length during your one-on-one consultation with a board-certified plastic surgeon.

Ask yourself, "Am I happy with the size of my breasts when they are lifted up in a bra?"
If you are, you don't need a larger implant, you just need to have the implants placed higher on your chest wall.
BTW you can do this with a periareolar lift which will leave minimal scars. A repair of the capsule in the bottom part of the bra will insure higher placement of your implant.
If you are not happy with the size when you are in a bra, you need a bigger size implant, to address the size issue, and a lift to ensure higher implant and nipple position.