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. A breast lift restores a firmer, perkier, and more aesthetically pleasing shape to sagging breasts. This not only can improve a patient’s appearance by restoring her youthful, feminine proportions, but also help bras and swimsuits fit more comfortably and attractively. By removing excess, stretched out skin, reshaping the breast tissue, and raising the nipple & areola into a more forward position, a cosmetic surgeon can create a more youthful breast contour. Stretched, large areolae can also be reduced during breast lift surgery, creating an overall better proportioned, natural looking breast, Actually the perkiness on a person or another, depends on patients skin and breast tissue!
Thank you for your question and photos. From what I can see, you would do well with an implant to increase the upper pole fullness combined with a small reduction/lift to remove excess lower breast tissue and move the nipple onto the center of the breast. You would have an incision around the nipple/areola (to move up into a higher position and make the areola smaller) and a vertical incision to shape the breasts and move them up higher onto the implant. In my practice, you would also likely have a small transverse incision under the breast in order to remove the excess, bunched up skin at the bottom of the breast that forms after a vertical breast lift. Best to check with a board certified plastic surgeon to discuss your implant options and devise the best plan for your anatomy. Good luck.
Thank you for your photos and question. In my opinion you clearly would benefit from a full mastopexy at the time of breast augmentation. During the surgery your surgeon should place different temporary sizers while tightening your skin to make the best selection to balance your size and contour goals. I personally don't agree with having the patient responsible for the actual implant selection since there are so many variables at the time of surgery. Others may disagree.Best wishes and good luck.
Jon A Perlman M.D., FACS
Diplomate, American Board of Plastic Surgery
Member, American Society for Aesthetic Plastic Surgery (ASAPS)
Beverly Hills, California
Consult with a board certified plastic surgeon for measurements and sizers for a clear understanding of the volume being added to your breast. Breast lift surgery will reshape your breast for a pleasing cosmetic result.
I would suggest meeting with a board certified plastic surgeon and discussing all your concerns and options. During the consultation, you will be measured and can try on a range of implants that best fits your frame and tissue. You can also see what size you prefer. You might also consider just a lift if you are content with your size.
and in my experience, the only options I would offer are the Rubin mastopexy (if you were fine with your size) or an anchor reduction with use of an inferior based flap to provide inferior coverage of your implant and to reinforce the lower pole. The the latter scenario, you are giving up your own breast tissue to have a more durable and perky look. Simply doing a mastopexy (attempting to salvage all of your own tissue) with implant will not withstand the test of time so be cautious if that is the only choice you are offered.