Breast implants/lift for woman with naturally large HH breasts? (Photo)

Without examining you I cant be entirely sure but it sounds like what you would need to achieve those results is a vertical pattern lift (a.k.a the lollipop lift). This would correct the sagging and provide excellent projection of the breasts giving the perky appearance you desire. An implant could certainly be added if you wanted to increase the size of your breast in addition to lifting them. The only way to know for sure is to book a consultation with a board-certified plastic surgeon near you. Best of luck! 

You seem to have ample breast volume, and would not need implants but rather a breast lift (also called a mastopexy) to achieve a better shape.

With naturally very large breasts, it would generally not be advisable
to add implants on top of the weight from your already HH breasts, especially
if you’re wanting the breasts to appear higher. This would only add to
the weight of the breast tissue. If you want the breasts to be higher,
then a breast lift or mastopexy would be the primary procedure to
consider. Hopefully this is helpful to you. Best of luck!

Hello dear, thanks for your question and provided information as well.. The breasts may lose their elasticity and firmness
which can be caused by different factors such as pregnancy, massive weight
loss, lactation and aging. To reaffirm the breasts and restore the natural look
your surgeon can perform a mastopexy or breast lift, such as silicone implants, you can have also just a breast lift with reduction if you don't want them to be too big. Hugs!

A breast reduction will reduce the volume, and lift the breasts for you. It does not look like you need implants.