Why do these implants look saggy? (Photo)

First of all I do not know for sure what caused this appearance. However, my guess is this patient had very deflated sagging breasts and tried to fill up the deflated breasts with giant implants above the muscle and not have a breast lift to avoid the scars.If so this proves that implants do not lift or reposition breasts. Discuss  your concerns with your plastic surgeon. Good luck.

They can look like that for multiple reasons.  It can depend upon where the natural breast base appears onto chest, some are lower than others, and two, it can be because the implants are too large, or she has poor support and needs a lift as well.