Can I get implants under twilight? (Photo)

The short answer is yes you need a lift under a general anesthetic.

The explanation is you have droop (or what we call ptosis) as well as a tuberous breast and the only way to correct the shape and lift the breasts is with a full mastopexy augmentation where an implant would be placed and then a inverted 'T' style lift performed. The implant would give you volume and the lift would reduce your areola, position your nipple in a better position, and round your breast.

It appears that you may have lost a reasonable amount of weight and your breast ligaments are somewhat weak so I would also suggest using a mesh like Strattice or Galaflex. I have included a video on lifting for you.

I would recommend implants with a lift. I would not recommend to do anything under twilight anesthesia in general. This is because there is no formal airway protection.

Technically, you can get implants under IV sedation. However, you will just have larger and still sagging breasts. You would get your best results with a vertical lift and placing implants behind the muscle.