Help! Only 5 weeks post op and already starting to sag again. Options? (Photo)

This is an excellent outcome from your surgery.  If you are disappointed, the plastic surgeon may have done a better job educating you about the possibilities after surgery.

Prior to answering your question, I have a few questions. 1. Size of implants. 2 position of implant 3 type of lift. Once I know these answers I can answer your questions

Hi, do you know if your implants were placed sub glandular or sub pectoral?   Your implants will likely continue to settle some since you are only 5 weeks out. Sub muscular placement and or textured implants can help minimize this, but there is always some amount of settling post procedure. You appear to have nice early results. I would give yourself 3 months to heal and then re-evaluate. At that point you have the option of fat transfer to the breast to add some upper pole fullness or a possible implant exchange. I wouldn't do anything before 6 months post op given your current results.

Your breast implant will continue to settle. One way of reducing the risk of implant and lift settling is to use an internal bra technique that uses a permanent plication method. Best, DR. Karamanoukian Los Angeles

Based on your photos you are exactly right you have a long chest and your breast position on your chest will likely not allow you to have a "busty" appearance.  The side view photo shows your nipples well above your breast fold.  In my opinion I don't think your breast could be lifted much more and would consider this a good result.  I agree it would have been better if this was explained before surgery.  You could wear an underwire bra if your not doing that already during the first 2-3months post surgery.  Best of Luck.