Based on your history you need a breast reduction. Breast implants will simply make your current breasts bigger.
If you are seeking a lift and reduction, then implants are not for you. Implants are for breast enlargement procedures.
If you have very large breasts and want a reduction, then you should not need breast implants they will only increase the volume.
If you have excess, un wanted breast tissue with a breast profile, you could reduce and reshape your breasts with a procedure called auto-augmnetation msstopexy. Auto-augmentation mastopexy is a surgery in which some of the patient's own lower pole breast tissue (from the area of the breast below the nipple/areola complex) is moved into the upper pole of the breast. A pocket is created behind the upper pole of the breast and the lower pole tissue is advanced, with its blood supply intact, into the upper pole pocket. This truly remarkable procedure can create a mastopexy appearance that previously has only been possible by means of breast implant placement. Not all patients are good candidates for this procedure, as there must be an adequate volume of lower pole tissue available to produce significant upper pole (cleavage area) breast fullness. Most patients undergoing auto-augmentation mastopexy in this practice have a full B cup to D cup breast volume preoperatively.
If you want smaller breasts, do not consider an implant, even if it is in conjunction with a breast reduction.
You don't mention weight, or BMI. some worm are at a weight that puts them at a higher risk for complications and therefore, some physicians will ask that they lose weight prior to a procedure. With more details, we could provide more information.
You mentioned that your breasts are huge and saggy---- if they are---- putting an implant in it whether silicone or saline will make it even bigger.... You need to be examined by an experienced Board Certified Plastic Surgeon.
I am a little confused -
having implants will make your breasts larger, not smaller.
Unless you have a breast reduction at the same time to reduce the breast volume,
Then use the implants to shape the breasts.
Since you have been rejected for a breast reduction, perhaps you might try losing the weight - or, if Canadian insurance covers it, have a gastric bypass if you are more than 100 pounds over your ideal weight. Best wishes.
SIlicone implants will increase the volume of your breasts and a reduction reduces the volume. Of course it is possible to perform a reduction and an implant and redistribute the volume so that one reduces the lower portion and places an augment in the upper pole at the same time as a lift.
If one reduces the lower pole considerably and places a small implant in the upper pole this can give good results but I think you need to consult with an experienced PS to work out what you are trying to achieve.