Refusing breast lift and choosing implants only. Deflated 36C.

Far more important than the technique is the skill and experience of your plastic surgeon. Choose your surgeon rather than the technique and let them explain why one technique may be better than another.  See the below link on some suggestions on finding the most qualified Plastic Surgeon for a Breast Augmentation Always insist on a board certified plastic surgeon.

A breast augmentation is often performed in patients looking to replace volume lost from weight loss, breast-feeding, or age or to increase the size of the breast for aesthetic reasons. The ideal candidate for an augmentation alone is a woman with good skin quality who lacks breast volume but whose breasts do not sag and whose nipples are otherwise in good position.
The decision to do an augmentation by itself versus an augmentation with a lift is less based on patient preference and more dictated by the nipple position and the ratio between the post-augmented breast volume and the amount of excess skin you have. The less volume, the lower the nipples, and the more excess skin you have the greater the chance you will need a lift and the more of a lift you will need.
That being said, with grade 2 ptosis, it may be reasonable to have an augmentation alone with the understanding that a secondary lift may ultimately be needed to achieve your goals. 
See the link below for more info.
A detailed examination will help delineate the best surgical option. In office sizing and digital three-dimensional computer simulations can help guide your implant choices. Consultation with a surgeon certified by the American Board of Plastic Surgery would be the next best step.

Your previous question about weight loss ties in well to your current question and the need for a breast lift.  Even without seeing pictures, I can tell with significant certainty that if you have grade 2 ptosis (about 3-5cm of breast droop), and you plan on further losing 20-40 lb, your best bet will be a breast implant WITH a breast lift.Good luck.Mark K Markarian, MD, MSPH

You MAY be a good candidate for a submuscular dual plane II or III approach without a lift. This needs to be determined by a surgeon experienced in this technique. The alternative of using larger implants in a subglandular plane may be the "kiss of death" because you are taking stretched out skin and stretching it even more to accommodate larger implants to avoid a lift. They may look good for 6 mos until they descend and descend they will! Go for a consultation from an experienced surgeon.

Hello and thank you for your question.  The
best advice you can receive is from an in-person consultation. In patients with grade II ptosis, a lift with an implant will give a much better result than an implant alone.  The size, profile, and shape of
the implant is based on your desired breast size/shape, your chest wall
measurements, and soft tissue quality.  This decision should
be based on a detailed discussion with equal input from both you
and your surgeon.   Make sure you specifically look
at before and after pictures of real patients who have had this surgery
performed by your surgeon and evaluate their results.   The most
important aspect is to find a surgeon you are comfortable with. I recommend
that you seek consultation with a qualified board-certified plastic surgeon who
can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Dear shellyrene,Determining whether you need simply a breast augmentation versus a breast lift can be somewhat complicated. It depends on a number of factors including skin laxity and current nipple position. Generally speaking, if the nipples are lower than the inframammary line the patient will most likely need a breast lift. If the nipples are at or above the inframammary line we can generally get by with just a breast augmentation depending on the size of the implant the patient wants. I often still using implant when I perform a breast lift because it provides more upper breast fullness after the lift. To be sure a consultation with a board-certified plastic surgeon will help determine what the patient actually needs.Daniel Barrett, MD, MHA, MS 
Certified, American Board of Plastic Surgery  
Member, Am. Society of Plastic Surgery

Breast lift is an option. The choice of a breast lift would always depend on your desired look. Not all breast augmentation needs a lift as it is usually only an adjunct to breast augmentation. However, there are some women who exhibit breast sagging even before breast augmentation, which means it would be better to have a lift on the same day. It would be best to have an in-person examination with a board-certified plastic surgeon of your choice and discuss with him your expectations so that both of you could come up with one goal.

My experience with women who need a lift with implants, but only choose the implants,  is that they are almost never happy with the results.  You should be seen by a board certified plastic surgeon who can do an exam to determine what exactly your needs are, and then can discuss all of your options with you, helping you to choose what is going to best meet your desires.
 

In my opinion, patients are often not happy with just an implant if they have ptosis. They will not lift the breasts.  A formal lift is best.

Thank you for the interesting question.  I would suggest that you be very careful with your decision-making: undergoing breast augmentation surgery only, when breast lifting is also indicated, can be a "recipe" for an unsatisfactory cosmetic outcome,  disappointment, and potentially require additional surgery to "correct".  Also, generally speaking, I do not think that it is a good idea for patients to undergo breast augmentation surgery, with larger breast implants than they would otherwise select, in order to avoid the need for breast lifting.In my practice, if (based on significant clinical experience) I  feel that a patient will not end up with aesthetically pleasing operation with breast augmentation surgery only, I would not do the operation for her.  In this type of situation, patients are better off avoiding surgery altogether. Having said the above, there are cases where patients present with "borderline" breasts ( when it comes to  breast lifting indications);  often times, breast augmentation surgery alone is a viable option. My best advice: select your plastic surgeon carefully.  Do not select your plastic surgeon based on the fact that he/she will offer you an operation (regardless of the unsatisfactory aesthetic outcome that will inevitably result). You may wish to post photographs (frontal and side views with your arms by your side)  for more specific thoughts. Best wishes.