After breastfeeding, the breasts can lose volume and the skin can stretch. Implants can restore volume, but they do not truly lift the nipple or tighten loose skin. From the photo, you may have mild to moderate sagging. If the nipple position is still above or near the breast fold, implants alone may be possible, especially if you want a natural result and only need more fullness. But if the nipple sits at or below the fold, or if there is loose lower-pole skin, a lift will likely give a better shape. Choosing implants alone when a lift is really needed can create a “waterfall” look, where the implant sits higher and the natural breast tissue hangs below it. That is why nipple position and skin quality are more important than cup size alone. If you want to avoid lift scars, it is reasonable to ask your surgeon whether implants alone would be enough. But if your goal is a higher, tighter, more youthful breast shape, a lift with implants may be more predictable. My advice would be to have an in-person exam and ask specifically where your nipple sits compared with the breast fold. That will usually determine whether implants alone are safe or whether a lift is recommended.