In my practice, I always evaluate each patient individually. In some cases, placing implants alone can achieve a full and balanced look, while in others, the degree of sagging makes adding a lift the better option. If the breast tissue isn’t very droopy and the skin quality is good, I usually prefer to start with implants only. Some mild sagging over time is expected, but since you don’t mind that and are open to a lift in the future, this approach is reasonable. However, going for the largest possible implants increases the weight and tension on the tissues, which raises the risk of sagging and shape changes later on. I don’t focus on placing the biggest implants; instead, I prefer choosing an implant size and shape that best fits the patient’s body proportions and natural symmetry. This provides a more balanced, long-lasting, and aesthetically pleasing result while keeping the tissue safe and minimizing long-term complications. If your tissue allows, starting with implants only is a realistic and effective option, as long as the implant size is chosen to complement your anatomy.