Thank you for your question. Based on your pictures, what type of breast or mastopexy do you need, and what kind of ptosis do you have? Based on your pictures your nipple-areola complex is above your infamammory fold. Therefore you have pseudo ptosis. Pseudo ptosis usually can be fixed by straight augmentation, mentioning that upper pull fullness is not a priority. In surgical approach to your breast, I would ask you if you want your breasts bigger. If you want your breast s bigger, I will go with a small implant and a lift. If you do not want your breasts more prominent, I will go solely with a lift. The lift I would suggest either would be a 360 circumferential perearelor incision with a vertical extension (lollipop) or an anchor incision around the areola down in front of the breasts and underneath the breasts. The lollipop and anchor mastopexy will give you a solid breast lift. The implant is totally up to you. It would improve the upper pull fullness and the overall appearance of the breasts. I hope this helps answer your question of what type of breast lift you need and what kind of ptosis you have. If you have any more questions regarding the breast lift or mastopexy, capsular contracture, or breast implants in general, please contact my office. Since your breast surgery is somewhat complex for an average plastic surgeon, please seek an experienced, board certified plastic surgeon with significant experience performing these types of breast lifts. Do your research. Make sure your chosen plastic surgeon has performed at least 100 breast lifts. Make sure they have the before and after pictures to prove it. Carefully examine their before and after pictures and check their reviews on RealSelf. Good luck! Sincerely, Dr. Katzen. (“Verified” Plastic Surgeon, President of the American Society of Bariatric Plastic Surgeons, Certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, International College of Surgery, and American Board of Metabolic and Bariatric Surgery, and member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery and RealSelf Hall of Fame.)