Anatomical implants for saggy breasts or lift? (photos)

It would take a formal consultation with evaluation of tissue thickness and skin elasticity for any of us to give you a very meaningful opinion.  Based on the photos, if you want a very tight skin envelope and significantly higher breast and nipple position a lift would be necessary.  The trade off is a significant scar that should not be taken lightly.  To get the most "lift" as possible with the implant alone I would recommend an anatomical implant over the muscle (assuming you have enough coverage for the implant).  An anatomical implant pushes the nipple up more significantly and tighten and supports the lower skin envelope more.  Going above the muscle allows the implant to fill the breast more fully without compression and blunting the effect from the muscle.  I have many patients who have been told they "needed" a lift who were candidates anatomical subglandular implants and were very happy that they did not do a lift.  The link below is a recent realself.com post about a patient with a similar story.I personally never recommend going larger than you would like to get better "fill".  Ultimately this is defeating and you will end up both larger AND droopier than you would like several years later. 

I would either go with smooth round high profile implants or the lift.  The HP implants would have to be large and there would be still some residual ptosis.  However, the scarring would be less.  A lift would control the breast shape more but there would be scarring and the breasts would be smaller.  I would wait six months between the lift and implants if you did both.  I do not see any use for anatomic implants here.

Excellent question. There is no doubt
that you have some ptosis (sag) of your breasts, but could have an acceptable
outcome with implants alone. If need be, you can always stage
a vertical mastopexy at a later date. Make sure you choose implants that are
appropriate, proportionate and fulfill your desires and goals. It is not an
uncommon scenario that too large implants are placed to "lift" the
breasts resulting in too large and more saggy breasts . . . Good luck and thank
you for sharing.

Based on your photos, a breast lift with an implant may be your best option. Anatomic implants alone will not correct your sagging and tend to feel stiffer than regular silicone implants. 

During my Breast Augmentation consultation I estimate what volume implants you need by trying on externally, various sizes of implants.Usually my patients can tell quite accurately what volume they would like.Once this is done, an experienced Plastic Surgeon will be able to advise you if a lift will also be needed.Sometimes you can only tell after the implants are in place. This can be decised in surgery, or at a later time.If you choose larger implants, a more minimal lift will be needed.You will need to have a consultation will a Plastic surgeon.Goos luck.