Why do my breast implants look "flat" on top (even after a successful lift)? (Photos)

You have a very natural result with your implants and lift. Low profile implants are extremely flat and lack projection. For an improved fullness in the upper pole a higher profile/larger volume implant with a higher silicone cohesivity could be used. Additionally, a piece of bioresorbable mesh could be used to support your lower pole and create stability of your pocket, also enhancing the appearance of the upper pole. Finally, autologous fat grafting can be used to enhance the contour in the upper pole. All or none of these things could be utilized in a revisionary procedure for improved upper pole fullness and to create a more "round" appearance to your breasts.

Dear strawblonde91,
Upper pole fullness is achieved with appropriate implant selection but more importantly, submuscular placement, and precise pocket dissection. The submuscular placement allows the muscle to cover the top part of the implant which allows the upper pole to appear more full. Keeping away from the lateral chest during pocket dissection allows the implant to remain higher and prevents it from falling off to the side. 
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery