55, two children, 25 lb weight loss - 34B breasts sag but the nipples do not point downwards - Breast lift? Implants? (Photos)

Hi Kristin- this is a great question! you have something called "pseudoptosis". This is where the lower part of your breast sags but the nipple remains in good position. The best management depends on your goals. A lift alone would help with the sagging breast but would result in a rather small breast. In my opinion, adding a modest sized implant would greatly enhance your result and give you more upper pole fullness. Adding an "internal bra" generally refers to placing an absorbable mesh to support the soft tissue. In my opinion (and this varies greatly amongst surgeons), this is most beneficial if your select a rather large implant (over 350cc) and/or have a goal cup size of D or larger. Because you do not require a particularly large lift, I think that it would be completely reasonable to omit the internal bra. Best wishes for your plastic surgery journey!Alex Neusner, MDBeverly Hills, CA