Do I need a lift or will implants alone give me a decent fullness up top? 5 ft, 140 lbs. 22, 2 kids

Thank you for your question.  Breast implants would give you upper pole fullness.  If you also want improvement with your mild degree of sagging and nipple position, a limited breast lift may be added.  Be sure to consult with an experienced board certified plastic surgeon.  Good luck.

For most patients, I would say that some kind of lift (especially a Goes lift or my own  Tear Drop Augmentation  mastopexy) would be necessary to achieve superior pole fullness. However, in your case it seems as though an implant may work well for you. Not mentioned in your question is the saggy look of your breasts. While the implants may improve upper pole fullness, they will do little for the sogginess your pictures show. If you want both addressed, then my Tear Drop Augmentation Mastopexy is ideal for you.To learn more, read my book "Cosmetic Breat Surgery - A Complete Guide From A to Double D".