Saggy 36B looking to be a small lifted D. (photo)

You state you want to be a D but don't want high profile breasts. Implants that make you a D will not look natural.  Additionally, if you use large implants your breasts are more likkly to sag again more quickly, requiring a another lift.I would consider using a smaller implant with a vertical mastopexy. The result will be longer lasting, and your can always deres them up with a Victoria Secret Double Volumizer.Yours,Jon M. Grazer, MD, MPH, FACS

I think that an implant with a lift will produce the best result.  If you place the implant without a lift, I think that the breasts will look worse.Kenneth Hughes, MDLos Angeles, CA

 It's a close call but provided you want to be large enough a sub glandular silicone gel implant might be  able to camouflage your ptosis without a breast lift.

A
breast augmentation is often performed in patients looking to
replace volume lost from weight loss, breast-feeding, or age or to increase the
size of the breast for aesthetic reasons. The ideal candidate for an
augmentation alone is a woman with good skin quality who lacks breast volume
but whose breasts do not sag and are otherwise in good position. This procedure
often uses silicone or saline filled implants inserted through a small incision
to replace the lost volume.



A breast lift (mastopexy), in contrast, is often
performed in patients with breasts that are adequately sized but saggy. This is
a powerful procedure that can lift the nipple, remove excess skin (and
sometimes breast tissue), and reshape the breasts to sit higher on the chest in
a more youthful position. The trade off is a scar on the breast around the
nipple with a possible extension down towards the
breast crease creating a lollipop or inverted “T” pattern. The
size and location of the scar depends on the amount of lift needed, the patient’s
anatomy, and surgeon preference.



For patients with both a lack of volume and sagging
breasts, a combination of a breast lift and augmentation (mastopexy
augmentation) can address both issues. The incisions are often the same as for
a mastopexy alone.



A detailed examination will help delineate the best
surgical treatment. Consultation with a plastic surgeon would be the next best
step.

From your photos and desired results, it looks like you would be best served with a combination of breast lift with augmentation.  The parameters of both the breast lift and the position of the breast implants should be designed to keep the implants relatively low while lifting the breast tissue and nipple to sit directly over the implants.  Many techniques exist in breast surgery, and combined lifting with augmentation is especially tricky.  The key is working with an expert, board certified plastic surgeon to get the best plan for the individual.I hope this was helpful. Please let me me know if you have any other questions regarding the procedure. Thank you and best of luck. Dr. Campbell

Your breasts look larger than a B at this point.  If you do not want your nipples and areolae lifted to the normal position, and want larger breasts, implants are the way to go.  

Your photographs suggests that you would be a good candidate for a combined great augmentation with mastopexies (lifts).  The trade off for the droopiness is the scars associated with the lift.  The final look is not entirely predictable.  This depends in part on how you heal the implants in place, which no one can predict.  Some patients look like they have two half grapefruits on the chest and others more natural or tear -drop shaped.  

Thank you for your question and for the photos.I think that a breast augmentation with a lift or mastopexy is the ideal procedure for you.  It is really two procedures performed at the same time.  The augmentation provides volume replacement which is typically lost with age, weight loss, pregnancy and breast feeding.  Silicone implants provide a very natural look and feel.  The lift restores the nipple and areolar to a more youthful position and reduces the diameter of the areolar at the same time.Visit several board certified plastic surgeons in your area and get several opinions.  Check before and after photos and best of all try to get word of mouth referrals.Best of luck.

After reviewing your photograghs, I believe a breast lift with a combined augmentation would result in a uplifted nicley projecting D cup breast profile.

Dear Mercedes, there are a number of options that can augment and lift your breasts.  From your photo, I believe you will probably need some type of a breast lift  - the options include a donut lift, lillopop lift or a full anchor lift.  The donut type of lift would result in the fewest scars (solely around the areola), but would also give you the least amount of lift.  With regard to implants, again there are a number of options depending upon you present breast size and shape and your desired size and shape.  A physical exam would be necessary to determine which type of lift and implant option would be in your best interest.  Seek out a board certified plastic surgeon with extensive breast augmentation and breast lift experience and ask to see pre and post op photos of their work.  This should give you a good idea of what you can expect regarding results.  Best wishes, Dr. Lepore.