Can I avoid a lift altogether? If not, would I need a donut lift or lollipop?

A side view photo would help. However, based on your front view photo alone, it does appear that your nipples are located below your breast fold. This would make a full breast lift (anchor lift) more suitable. Without a lift, your implants would sit rather low on your chest.

The technique I recommend is a mini lift. Using a circumareola incision, your breast tissue is reshaped, elevated higher on the chest wall and more medial to increase your cleavage. At the same time, fat transfers or small implants can be placed totally submuscular.

Best Wishes,

Gary Horndeski, M.D.

Dear Spanishbaby1,
my preferred lift is a lollipop lift when a periareolar won't do (ie greater than 2cm lift required). The lollipop technique was created by a Canadian plastic surgeon named Elizabeth Hall-Findley and treats the breast as a three dimensional structure instead of two dimensions (anchor - lift). Most importantly it does not require the horizontal component scars that the anchor-lift requires and breasts appear much more natural, lifted, and less boxy. Lastly, the lift lasts longer because the lollipop doesn't rely on the skin to hold the breast up, its actually breast tissue thats being brought together to support the breast and hence improves longevity. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Measurements are needed to be sure, but a lift would be best. You could just have implants placed behind the breasts, but you will have some sagging. You could then wait on the lift until you have all the children you want.

Based on 1 posted photo I recommend 450-550 cc mod profile+ implants with donut lift only. fees from $5,000-$10,000. Best to virtual consult with....

Hi and welcome to our forum!
From your photo, I note loss of superior breast pole volume, the nipples point downward, and there appears to be moderate sag.
Augmentation alone will provide larger breasts of the same shape. A lift will place the nipple areolar complexes into anatomic position and will conify the shape of the breasts and will add superior pole volume.
A periareolar lift will have a tendency to "pancake" the shape of the breasts. A lollipop lift will most likely achieve the result you desire.
Visit a board certified plastic surgeon for in-person evaluation and discussion.
Best wishes...