I'm 19, my breasts sag and my nipple faces more downward. I also have keloid skin. What are my options? (Photo)

Hi Lisa,The woman in the photo would need a breast lift along with her augmentation.  So I would guess, based on what you said, that you would need the same.  Be sure to see only a board certified
plastic surgeon (by ABPS - The American Board of Plastic Surgery) who is a
member of ASAPS (The American Society for Aesthetic Plastic Surgery) and or a member
of ASPS (The American Society of Plastic Surgeons). Also, ask if they have an
established, high volume breast augmentation practice, performing several
hundred breast augmentations each year. Ask to see their before and after
photos if you didn’t see any on their website. If they are experienced,
they should have several 100 breast implant patients for you to view. I
would also recommend that your doctor offer you the chance to talk to past
patients who would be happy to discuss their experience with you. You
need to feel comfortable, so make sure the environment is safe as in an
accredited surgery center. Also, ask a prospective surgeon if he or she has
ever published journal articles in professional peer-reviewed journals, which
they can provide you.All the best,
“Dr. Joe”

If you have sagging of your breast than the right treatment would be at least a breast lift. Sometimes a breast augmentation it would be necessary to give volume. Your main issue is keloid formation. If you truly have to keloid formation in my opinion I would not recommend surgery because the scars are long and every where there is an incision there is the possibility of keloid formation