Hello, And thank you for the question. Based on the pictures you provided, you appear to be a good candidate for a full mastopexy (breast lift) which will put your nipples into the correct position, make the areola smaller and allow excess skin to be taken away, giving you a more youthful, firmer and lifted breast appearance. Some people are a little apprehensive to the full breast lift due to the scars (lollipop or anchor), but typically they do very well and scars fade over time. Adding a breast implant to the breast lift would add more upper pole fullness and breast volume, but may not be needed in your situation. You appear to have sufficient amount of breast tissue and adding the breast implants should not be needed in your situation to create a fuller and more lifted cleavage. I suggest that you seek an in person consultation with a Board-Certified Plastic Surgeon specializing in Breast Lift surgeries to further discuss your options, specific techniques, concerns and expectations. 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. I hope this helps. Good luck! Dr. Irena Karanetz Breast Fellowship-Trained Board Certified Plastic Surgeon Queens, New York (516) 833 0309