Do I need a lift & if so what type? What Implant would look good? 158lbs, athletic frame (Photos)

Hi, thank you for your question.

The photos you provided are not ideal for an evaluation of a breast lift because, you would have needed to take some photos from the side view and frontal view with your arms down.
But with this photos we can see that, you have excess skin surrounding your breasts and asymmetry. Asymmetry is normal from one breast to the other. Your left breast is higher than the right, also you could use more projection. The nipple position has changed, probably due to pregnancy or breast feeding You would be a good candidate for a brest lift, using Superior Pedicle Technique and, breast augmentation.
The breast Augmentation depends on how much is your own volume of breast tissue and how much volume you desire. The ideal body balance is to create symmetry between the thoracic diameter and the hip diameter. By taking all these measurements we can then determine implant volume and projection.

Your nipples appear to be located below your breast fold, which would probably make a vertical lift suitable for you. It would be a good idea to bring in a bra in the size you’d like so you can try on sizers. Sizers are implants in a range of sizes that you can fit into your bra. This will give you a better idea of how may look and feel after surgery. Your surgeon will also recommend a range of sizes, based on your goals and current body measurements, to help you achieve your desired results.