Thank you for your question. You are correct, based on the pictures you provided you have 2nd degree droop. Your breast volume seems adequate, so the primary correction is a lift without implant. Our lifting techniques in recent years have included a significant amount of upwards gland mobilization and internal breast parenchyma suturing along with chest wall plication for more long lasting results that don't simply depend on the skin tightening to maintain support. You could add an implant if you want a bigger breast size, but I would not recommend it given your adequate current breast volume. The weight of the implant would accelerate the deterioration of shape in the long term. I would frequently add an implant in a case such as yours earlier in my career in an effort to satisfy their desire for D or DD cup. Having performed over 12,000 Breast surgeries and 8,000 implants over the last 25 years and having had the privilege of long term follow ups on my patients, I have come to the consensus that the weight of the implant in a patient starting out with a full C, as you are, significantly compromises the long term results. In fact the best long term results for lift procedures are in countries where the aesthetic "norm" for breast sizes are smaller than those in the US. Brazilian surgeons at international meeting routinely show 10-20 year follow up pictures that have withstood the test of time, as their patients are content with B and C breasts as opposed to D and DD. Remember the reason your breast are ptotic or droopy is because they have been stretched and have lost elasticity. No matter how effective we are as surgeons in restoring shape, the biggest predictor of longevity is the amount of weight exerted against the skin flaps long term. "less is better".
