To lift or not to lift? And what about scar tissue? (Photo)

Just based on your photos, you will need a lift, especially if you lose more volume with weight loss. Once implants are replaced and you are lifted, if you have any indentations, fat grafting can be done later.

First of all, you will have better results after losing your weight. Based on your photos, your areolae are being pulled in by your retained capsule. I would recommend a capsulectomy which will release the tethered areolar scar, perhaps placing acellular matrix underneath the incision to help prevent it from reoccurring. Furthermore, I believe you would benefit from either a Benelli mastopexy(around the nipple) or a vertical lift. I hope this helps. Good luck.

The technique I recommend The Bellesoma Method. This will reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained. Later, fat transfers can be performed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.