How can I fix this without implants? (Photos)

If we can’t use implants, fat grafting is the only option. Fat grafting is unpredictable and does not fill-out the breast nearly as much as implants do. But it seems to be your only option, so if you want surgery fat grafting will have to do. I believe you will probably need several rounds of grafting to achieve good results but it will be worth it.
Best of luck,
Dr. Miguel Mota

Your aversion to using implants is very understandable. Ultimately your options will depend on your goal for your breasts, however you may consider fat transfer or an off-the-shelf product such as Renuva or Alloclae to build volume in your breast(s). This is a good place to start to then achieve better volume symmetry between the breasts. More volume will help to smooth out the skin and fill the depression created by your prior tissue loss. A lift is possible, and can also help to create more symmetry between the breasts, but I would recommend improving the volume first.

Unfortunately, scar tissue deformities from previous multiple complications will persist and limit results no matter what procedure is performed.

Without implants, volume can be improved with fat transfer. However, underlying muscle and soft tissue contractions, indents, etc will likely remain to some degree.

Fat transfer with a loft the other side should improve symmetry as well.

An exam and consultation with a plastic surgeon who performs these procedures is recommended to confirm you are a candidate as well as discuss your options and expectations.

Hello- thank you for sharing your pictures. Fat transfer is a good option to help improve the contour of the right breast. It also appears like the Areola and Nipple are puckering down. This can be improved with a combination of the fat transfer and a doughnut style lift. If your muscle was disinserted and animating with flexion then a formal muscle repair can be performed to improve muscle function and reorient the muscle to its normal anatomical position. Hope this helps,Dr DevENSOPlasticSurgery

Hi, thank you for sharing your question. If you prefer to avoid implants, fat grafting may be a good option if you have fat to donate. This is somewhat unpredictable for a variety of reasons. You may also benefit from a lift but a formal exam would be helpful to determine this.

Achieving a nice aesthetic result will depend on creating more symmetry in terms of volume and breast shape. If we are not considering implants, increasing volume can be address with fat transfer. That requires fat to be removed from some other location on the body (abdomen, flanks, back, arms, thighs, etc.) via liposuction, and then transferring that fat to the breasts. Fat transfer to the breasts is not a 1:1 procedure though, so it is less predictable in terms of the final outcome in terms of volume than implants. About a third of the fat that is transferred will not survive. So the surgeon will purposefully overfill the area to compensate for the fat that will be lost. Fat transfer also is not equivalent to implants in terms of shape or volume. Fat that is transferred acts like fat anywhere else in the body. Since it's not contained without a shell like an implant is, the fat has be transferred very precisely for the best possible outcomes. Most people who get fat transfer to the breasts will also only achieve about 1 cup size of 'augmentation.' So I would not expect to go from your current size all the way up to a C or D.
Another option, like you suggested, is a breast lift. In most cases, that is going to require incisions that look like an anchor (around the areola, underneath the curvature of the breast, and from the bottom of the areola down to that curvature). For that option, more breast tissue can be removed from the larger breast to create better symmetry in terms of volume. Based on your photos, the breast lift option would leave you with only a small amount of breast tissue though.