Would breast implants alone help me achieve fuller perkier breast, or does it look like I need a lift as well? (photos)

You need a formal evaluation by a licensed plastic surgeon and expert in breast augmentations to determine what is best for you and your goals.
Proper breast enlargement is not a ""cookie-cutter"" procedure where the same technique is applied to every patient. Every woman who comes to my practice has unique needs and different goals for her breast augmentation. As a board-certified plastic surgeon, I always listen carefully to each woman's concerns and thoroughly discuss the key points of the procedure. I also take into account their overall height and weight, the size and shape of the underlying chest and ribcage, the tightness and elasticity of the skin, and the amount of natural breast tissue. Prior to the procedure, we discuss and make decisions regarding location of the incision, whether to place the implant under or over the chest muscle, and what type of implant to use (I offer multiple types of silicone gel breast implants, as well as saline implants).
My experience performing thousands of aesthetic breast surgeries in a wide anatomical range of patients enables me to achieve consistently beautiful and natural results that are customized to each patient’s body type and goals. These results are the product of extensive communication, meticulous planning, and skillfully executed surgery.
I suggest consulting with a board-certified plastic surgeon and expert in Breast Augmentation surgeries. - Dr. Cohen

Hi, thank you for your question. Based on your photos, you will, in my opinion, benefit from a dual-plane breast augmentation without the need for a lift procedure.  Ideally, this choice should be determined after an evaluation of your nipple position and skin quality. The breast lift, or mastopexy, will move droopy breasts to a more youthful position and help tighten the loose skin. 
If choosing an implant alone or in combination with mastopexy, the type of implant is based on your chest wall measurements, soft tissue quality and personal goals.  After a consultation with a board-certified plastic surgeon, during which you can discuss your goals and concerns, you can come to the optimal decision together. 

I hope this helps. Best of luck!

hello thank you for your question and provided information as well.. based in your question and the picture you showed you are a good candidate for breast lift with implant , in your case with small implant to get projection.

Hi.  Based on your pictures I think you could receive a nice result with implants alone.  Some women may like a little bit of additional tightening that could be achieved with a lift, but with your history of keloids you would likely be best served with a breast augmentation without a lift to avoid the additional scars.  I would recommend consulting with a board certified plastic surgeon with good experience in this area who can guide you through the process and discuss the options for you specifically.Good luck and take care, Dr. Howell

To most accurately answer your question would require an examination. However, based on your photos alone, it would appear that you could achieve a good correction with implants alone . The drooping , or ptosis that is present is primarily due to volume loss . Generally speaking , if the nipple is located at, or above, the crease below the breast (inframmary fold), adding enough volume will restore perkiness. If the nipple is located below this level, a mastopexy or lift will be required as well. There is still some risk of keloid formation with augmentation, but it is greatly reduced.

Hi.  I would recommend that you have breast implants alone.  This will give you much better shape and fullness at the top of your breast.  It can be done with MUCH smaller scars than those that are required for a lift.  You may have a little "natural" curve with the bottom part of your breast if you don't do the lift, but I think this is an acceptable trade-off, since the alternative is to do the lift.  If you do the lift, you have the potential to get a slightly more perky appearance, but definitely risky to develop keloids.  I wouldn't want you to take that chance, since this could be an irreversible problem.  Hope that helps.  Best of luck!

For keloid formers, there is not a way to prevent keloids.  In general, the longer the scar or the greater the number of scars, the greater the chance for keloids. The keloids may require multiple modalities to achieve the best results.  Laser may help to some extent with some types of scarring issues. 
As an author of Scars and Scar Revision in Reoperative Plastic and Reconstructive Surgery, I am well versed in the potential treatment options.  One treatment may be helpful for one patient while another treatment may help another patient.Although breast implants and a breast lift would provide better results, breast augmentation can be performed first and a breast lift can be performed later if necessary. 

I think you would do well with a dual plane augmentation without a lift since your nipples are above your breast fold. However this will not give you a super perky look. For that you would need to add a lift with its cost and scars. If you were my patient I would probably recommend an augmentation alone and only add the lift months later if you feel the cost and scar are worth it . Good luck.

Hello and thank you for your question. Your breasts do not appear to have significant ptosis, that is, your nipple sits above your inframammary fold if you were to draw a line across the middle of your nipple in your first photo. In my opinion, you could opt in for implants without a lift, but it is difficult to tell from photos alone. Be sure to schedule a consultation with a Board Certified Plastic Surgeon to see what they think after a physical examination. Best of luck! 

Judging by your photos I would say that to achieve a great result, you would need a lift and implants.  Sure you can always place implants and see how things look, but in my opinion and judging by your photos, implants alone will leave significant amount of skin behind and will leave your nipple and areola too low in relation to your implants.I would go see a board certified plastic surgeon to be evaluated in person and to discuss your surgical options.Hope that helps.