If I get an implant removal, would getting a fat grafting/transfer help with any of the loose skin? (Photo)

An examination would tell how much more breast tissue you have now. You might want to consider going down in size with implants.

You will have some skin laxity following explantation but your age and photos suggest that you should have subsequent contraction of the tissues and may ultimately have an acceptable appearance. I would personally recommend delaying any fat grafting until the breasts have fully healed and matured. If you are unhappy, fat grafting could be done at a later date. There is a good chance you will find this unnecessary.

Once implants are removed, there will likely be flattening and drooping that can be corrected in large part with a breast lift. As far as the volume that is attained, that is a bit difficult to predict given the period of time that you have had the implants thinning the remaining tissue. No one can truly predict this as each soft tissue envelope will respond differently, but you may do well with just removal. If there is any doubt, explant using the original incision, followed by a period of several months of observation. After 6 months or so a decision for a breast lift with or without fat transfer can be made.