Possible to achieve more fullness at the top through this procedure?

Without seeing your breasts, I can can only go over what may be options, not what is an option for you. One way to fill the breasts and give more volume or upper pole fullness is fat transfer. We use the liposuctioned fat from another area such as the abdomen, flanks, or back and spin it down to usable condensed fat that would be transferred to breast. I usually recommend patients have at least 10 pounds of extra fat to be liposuctioned for a fat transfer of any type. Some patients need more or less, it depends on their body composition. With that being said, the scarring is minimal, just a few tiny poke holes where the fat is harvested and a few holes in breast so fat can be transferred inside. I would love to see you for an in person evaluation and consultation here at Smith Plastic Surgery so I can give you further details on how we can reach your aesthetic goals.

It's difficult to achieve upper pole fullness with breast fat transfer. Fat requires blood supply and vascular tissue to survive. There is a paucity of tissue in the upper pole so it takes much better if placed in the breast itself. Achieve upper pole fullness is more reliable with a full profile implant.

This is a great question. Traditionally, the best and most effective way to achieve more fullness at the top of your breasts is with a silicone or saline implant. Nowadays, fat transfer to the breasts can be a good option. It is a particularly good option for patients who desire an improvement of shape. While fat transfer can also augment the size also, it is not as effective as a breast implant to add volume. If larger amounts of volume with a fat transfer is wanted, it is necessary to perform multiple surgeries of fat transfer in order to achieve the size desired.
A lift can be done at the same time if needed. The scarring for a lift depends on several factors like skin quality and the degree the breast has dropped. Although a breast lift can initially improve the contour and size upper part of the breast, only implants and/or fat can give lasting fullness at the top. Hope this helps!