Looking at your photos, the nipples are at the lowest point of the breasts (Grade 3 ptosis). In such cases an uplift will remove extra skin and lift the nipples. The nipple size (the diameter of the dark circular areola) can also be reduced to improve the look, if that is what you wish.Some surgeons suggest having breast implants to avoid an uplift. I think you cannot choose this option (unless you want to have huge huge implants! These will drop down very quickly in any case, so definitely a bad idea).After an uplift only, the breasts often look and feel smaller, so you might want to consider implants as well if you think this will be an issue for you. Try on a non-padded sports bra and look at the size of your breasts. If they are big enough, then an uplift only is a good option. If too small, maybe combine an uplift with implants. If they are too big, then a breast reduction is for you. Good luck!