What are my options to create fullness after a Breast Reduction? (Photos)

in that there is 'bottoming out' and loss of upper pole fullness.  You can correct this with a shortening of your lower pole with a transverse plication (utilizing your transverse scar if present) with possible fat grafting to the upper pole.  Implants are only needed if you wish to be significantly larger.  Realize that there are no results that are permanent and if someone suggests that they can achieve permanent, go for it BUT get it in writing and know what happens if your results sag again.  

Hello!  Overall, your postoperative outcome is very nice.  You actually have very elastic tissue as can be seen in your preoperative photos (your breasts are stretched and almost all of your breast tissue is located at the bottom of the breast creating a hollowed-out appearance of your upper chest).  So, this will cause your breasts to stretch and regain that type of shape after surgery.  A few things that you can do to try to regain more upper pole fullness are placement implants, fat grafting, or auto-augmentation to relocate some of your breast tissue from the bottom of your breast to the top of it.  

If you want to have the same size and shape as when you were swollen, an implant is the best answer.  If you only want a small addition to your volume, than fat grafting can be done.  But, fat transfer can only increase the size of your breast by about 1 cup size unless you use a BRAVA system.  Auto-augmentation using the same tissue of your breast and rearranging it to fill out the upper pole will not add volume to the breast, but may add some fullness to the upper portion.  

Overall, you have a very nice shape to your breasts after surgery.  Talk to your plastic surgeon about your options if you want more volume in the upper portion.  Good luck!