Breast lift without implants after weightloss surgery.

Thank you for your question. Based on your information you appear to be a good candidate for a breast lift, which reduces the skin envelope while reshaping the breast tissue into a more youthful and perky shape.  Sometimes implants can also be added for more volume.  The key is working with an expert, board certified plastic surgeon to get the best plan for you.

I appreciate your questionFrom what you describe you will most likely benefit from an implant along with a breast lift. 
After performing hundreds of breast augmentation-mastopexies (breast lift with implants), I think the most important thing I try to convey to patients is that this surgery is a lot more complex since it is a combination. We are increasing the size of the breast  by placing implants while simultaneously making the breast smaller by removing skin to perform the lift, which tightens the breast.  This could lead to complication loss of skin and the nipple due to vascular compromise. Also since most breasts are asymmetrical there is a larger possibility of having asymmetry after the procedure and meeting a revision.
I have found that the size of implant best for you is dictated by your chest wall measurements. Once we determine that we can choose the profile based on what you want or need to achieve.  If you are seeking a natural look, then the diameter of the implant should be equal to or, more ideally, smaller than the width of your breast. The breast width is a measurement of how wide your breast is at the base, which should be measured at the level of the nipple. Choosing an implant that is smaller in diameter than your breast width will avoid the "side breast" fullness that is often associated with a more artificial appearance. Bringing photos as well can help us to finalize, but please understand that these are of other people’s bodies and your results will probably be different.
Silicone will give you fullness at the top (upper pole fullness). Silicone implants come pre-filled with a silicone gel and are the softest implant available. They feel more natural, which makes them a good option for women with less natural breast tissue; but they require a larger incision. It may be more difficult to realize if this type of implant has ruptured, so it is important to monitor them with annual follow-up visits. Additionally, because this implant contains a softer silicone (less cross-linked), if this implant should rupture, it may leak but only into the scar capsule formed. However, the newer silicone in these implants may not leak even when the implant shell is ruptured. 
Anatomic gummy bear implants might be a good choice to give you a more natural look. These highly sought after, anatomic implants offer a look that more closely resembles the natural silhouette of a breast and is a very attractive option for individuals seeking a natural-looking breast augmentation. Additionally, these implants are an especially excellent option for patients undergoing restorative or corrective breast surgery because they provide more stability and shape. Compared to other types of silicone gel implants, the silicone in the cohesive gel implant is more cross-linked; therefore, should the implant shell “rupture,” it maintains its shape and silicone does not leak.
Saline implants tend to be firmer and less natural looking. They are a silicone shell that is filled with water. They have a higher chance of rippling if you are thin especially on the side. However if the implant does structure your body will absorb the water and you will know right away about the deflation. 
During your breast augmentation consultation, you will feel the different types of implants available, and try on various implant sizers in front of a mirror to help you to get an idea of how you will look following the surgery. You should also bring pictures of the look you would like to achieve, as well as a favorite top to wear when trying on implant sizers. I also use a 3D imaging system to allow you to try on a variety of shapes and sizes. I prefer this method over adding volume due to implants being under the muscle.
We will also discuss the possibility of needing a lift along with an implant. This will depend on the amount of ptosis (nipple position) as it relates to your breast, inframammary crease and chest wall. Needing a lift or not will also determine where to place the scar for the incision.  In some cases if the breast and nipple is really ptotic (low) it might be best to stage the procedure by performing a lift first and then doing an implant at a second stage. This will also allow you to have a better understanding of the true size and shape of your breast. The Scar patterns are determined by how much is skin we need to remove how are high up we need to move the nipple. If your breasts are very large, you might benefit fro  my lipo-lift procedure and the fat we remove could be used to increase the size of cleavage of your breast while lifting them.
The best way to assess and give true advice would be an in-person exam. Please see a board-certified plastic surgeon that specializes in aesthetic and restorative breast surgery.
best of luck!
Dr Schwartz
Board Certified Plastic Surgeon 
#RealSelf100Surgeon
#RealSelfCORESurgeon