Of course you have to be seen in person, but some patients have the "foundation" of the breast low on the chest, and sometimes as much as we want them lifted high towards the clavicles, this might not be possible.
It appears you need a lift suspension, where the breast is suspended to your rib cage to help prevent falling. Also whirring a bra will help your skin from stretching out and falling. Good luck...
It is critical to fit the skin envelope to the breast shape and this may require the proper choice of skin incisions and the type of mastopexy. A vertical or lollipop mastopexy often leaves the breast bottom heavy. In order to deal with the excess skin in the horizontal direction an inverted T shape or an anchor incision may be necessary. An in person examination may confirm this recommendation. Mastopexy augmentations can be very challenging procedures. The surgeon must have a lot of experience in breast procedures and know the advantages and limitations of each technique.
Thank you for your question. In looking at of your breast shape before and after these various operations I can see your cause for concern. As you point out, the breast is a bit rounder because of the lift, but they are still positioned down on the chest. It appears that the implants are still positioned too low -- this would need to be addressed separately during the lift with a capsulorrhaphy, as lifting the gland alone will not reliably raise the implants. You can bring this up with your Plastic Surgeon at your next visit.