Can someone please advise what grade of ptosis this appears to be?

Good afternoon!
You don't have ptosis, you just need a capsulotomy so that your implant can fully drop and fluff- no lift needed, just a little adjustment of your capsules! eezy peezy!

You do not have ptosis. Your breast implants are placed high on the chest wall, totally submuscular and the breast tissue is falling off inferior. The technique I recommend is a mini lift. Using a circumareola incision, your breast tissue is reshaped, elevated higher on the chest wall and more medial to increase your cleavage. I do not recommend changing implants or lowering the pocket as this will result in inferior descent of the breasts.

Best Wishes,

Gary Horndeski, M.D.

Dear beaniebaby65,
my preferred lift is a lollipop lift when a periareolar won't do (ie greater than 2cm lift required). The lollipop technique was created by a Canadian plastic surgeon named Elizabeth Hall-Findley and treats the breast as a three dimensional structure instead of two dimensions (anchor - lift). Most importantly it does not require the horizontal component scars that the anchor-lift requires and breasts appear much more natural, lifted, and less boxy. Lastly, the lift lasts longer because the lollipop doesn't rely on the skin to hold the breast up, its actually breast tissue thats being brought together to support the breast and hence improves longevity. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

If you look at charts on breast lifting, the key to really needing a lift is where the nipple sits in relation to the crease under the breast. Yours looks to be above so no lift is absolutely needed, only a periareolar at most. If what bothers you is the unnatural buldge in the upper pole, you can better drop down in implant profile. Don't try to lower the implant to fix this as it will open up the risk of double bubble and bottoming out. So, either a PA lift or a lower profile implant will make a better look.