From the look of your photos, with very thin overlying tissues a submuscular implant will be better. Because your breasts have migrated so far down the chest wall it will also be nessary to move the breast tissue back up on the chest wall with a vertical lift. In my experience, small implants and large amounts of skin removal in this situtation have longer lasting elevation of the breast on the chest wall. Good luck.
To Lift or Not To Lift?
I think a donut mastopexy with implants will look awesome! Under the muscle silicone is the way to go!
Breast lift with implants
Thanks for your question; in my opinion in your front picture there is some pseudoptosis; you are a good candidate for a breast lift with implants, it will improve upper pole fullness; and the position of the areola will be returned to a more aesthetically one.
Breast Augmentation vs. Breast Augmentation with a Lift
It is difficult to determine this by only looking at a frontal view of the photograph. There is however some ptosis (sagging of the breasts). It would highly benefit you to go consult with a Board Certified Plastic Surgeon in person to get the best results possible.
Need for mastopexy with BA
Hard to tell from photos without an exam, but really depends on what type of result you are looking for. Patients who are potential candidates for a lift and undergo augmentation alone appear much lower on the chest wall. This works well for some patients. IN general the larger the implant, the better this works. For those looking for a more elevated appearance with upper pole fullness, a mastopexy is then usually required. In-person encounters can tell us more specifics like skin redundancy, soft tissue quality, and exactly what someone is looking for. Experiencing a consultation with a board certified plastic surgeon will provide you with all of these.
Implants with a lift
Based on your pictures, you definitely would benefit from a breast augmentation and possibly a lift. You need to be examined by a board certified plastic surgeon to fully assess the level of ptosis (sagging of the breast) and quality of the skin/tissue in order to choose the right operation for you.
Lift with implants
While you only posted the frontal view, it does look like you have some ptosis and would likely need a lift with an implant. An exam in person is the best way to determine this.