Will I Be Happy with a Breast Lift Alone and No Implant?

If patients are fortunate enough to have enough volume, but have droopy breasts, I encourage them to have a breast lift and not to have an implant.
Breast implants can cause a lifetime of repeat surgeries... why subject yourself to that if you have enough breast volume? If the nipples are at the inframammary folds now, the breasts are probably droopy and probably require a breast lift.
For patients whose breast volume is insufficient, breast implants are wonderful, and there is currently no better alternative in my opinion.
As for the aesthetic ideal of great fullness in the upper pole, this is not a normal breast appearance; it is an augmented breast appearance. Although it is easily achievable surgically, the results are often fleeting as the increased volume causes quicker sagging, and the artificial superior fullness vanishes, only to leave the breasts thinned out, saggier and still without the elusive superior pole fullness.

Breast Lift with an implant best choice for  loss of upper breast volume  for a predictable result. I do not think you will be as happy if you do not restore the upper breast volume that "has been lost". Note that there are other options which I will describe in detail below. I also do not think you need an anchor pattern scar technique and for all practical purposes have abandoned that procedure about 15 years ago for a lollipop scar breast lift technique (and wish I had done it sooner !).

If you have been considering a Breast Lift or improving your appearance after breast augmentation or Breast Reconstruction but are not comfortable with introducing artificial material into your body, you may want to look into the benefits of breast augmentation with fat transfer. An alternative to breast implants is fat transfer also known as fat grafting or lipoinjection. This technique allows women the option of enhancing the appearance of their breasts without the potential problems of saline or silicone implants such as hardness, rippling or rupture. 

Who is a candidate?
Any woman who is healthy
Women with sufficient body fat for the procedure
Women considering breast augmentation who wish to be one cup size larger or less
Women who have had breast augmentation or reconstruction but who lack fullness of the upper breast such as what you described or have contour concerns. Fat transfer can further enhance and reshape your breasts while smoothing out visible or palpable edges of breast implants. This will disguise implant rippling and wrinkling.
Women with normal mammography
I have successfully transplanted fat into the face, buttocks and other body areas for decades and are now using this same technology to enhance breast shape and size. Plastic surgeons have been transplanting fat to the breast since 1995 but caution and study were necessary to make sure there were not harmful effects. Furthermore, results in the past were variable, dependent on surgical equipment, technique, surgeon’s skill, and individual patients healing abilities.

Since 1995, recent advances have led to the development of special instruments made just for fat grafting. Though this procedure is still considered investigational to a degree, more and more qualified plastic surgeons are using this technique successfully.   The advantage of this technique is its ability to create a natural augmentation without an implant. Fat grafting (also called lipoinjection or fat transfer) to the breasts is indicated for different reasons: as an alternative to implants for mild to moderate breast augmentations, to provide fullness to the upper part of the breast during a breast lift, after pregnancy, age, or weight loss, following breast reconstruction, or to minimize the visibility or rippling of existing breast implants. Typically up to one breast size enlargement is possible in most patients. Fat transfer to the breast is usually done as a single procedure resulting in approximately half a cup volume increase. In women desiring additional breast enhancement a subsequent procedure can be performed. Each surgery consists of two components:

Harvesting the fat: Fat is removed from your abdomen, hips, “love handles” or other areas using a fine cannula similar to the one used for liposuction but skinnier. This fat is rinsed with sterile saline solution and then packaged into syringes and prepared for transfer. Approximately 20% of fat removed is suitable and available for fat grafting.
Fat transfer into the breasts: The prepared fat is injected in small amounts at a time and widely distributed within the layers of the breast so that these living fat cells can pick up a healthy new blood supply.
Advantages of Fat Transfer to the breasts:
Fat cells are natural and you are using your own tissue without any foreign body or implant.
Harvesting of the fat by liposuction has the added benefit to enhance your shape by removing unwanted fatty deposits
The breast can be shaped or sculpted in more detail than is possible using implants alone.
Minimal incisions reduce the possibility and degree of scarring
No implant is used, therefore there is never a need for replacement, or any potential for capsular contracture (hardening of the implant).
Fast Recovery Time: Recovery time is about 1 week and usually less uncomfortable from implants that are placed beneath the muscle.
Although, breast augmentation performed with the lipoinjection technique takes longer than traditional breast augmentation (with implants) the benefits are substantial including no need for implant replacement in the future.

In the past, significant questions were raised about the ability of Mammograms or MRI to detect breast cancer after injecting fat into the breast. However, there is no evidence that fat transfer to the breast is less safe than any breast surgery. Large studies have begun over the last several years to study fat grafting to the breast. With or without breast surgery, calcifications and lumps can occur. Breast diagnostic studies including physical examination and mammograms should be used to monitor every patient diligently using standard guidelines.

As a general rule, surgeons with extensive experience in grafting large volumes of fat to the body are most likely to obtain the best results. We believe fat transfer should only be performed by surgeons certified by the American Board of Plastic Surgery that have experience in  fat grafting. Few plastic surgeons have this experience. This ensures that your surgeon has advanced knowledge and technical familiarity, but also the subtle anatomy and aesthetics of breast augmentation.

Breast implants are placed to increase breast size.  You already have plentiful breast volume so don't add an implant.  Implants do not protect your native breast tissue from sagging again after a breast lift so you will have to protect them with a bra.

You already mentioned you are happy with your present size, therefore, no volume needs to be added.  A lift will reposition your nipple and areolar to the correct position and reshape the breast into a prettier and more natural shape.  Fullness in the upper pole may be there immediately after surgery, but as the breasts relax that is usually not sustained.  An implant may give you some upper pole fullness but this added volume will mean your breasts will be larger and heavier and more weight will be on the new incision lines as they are healing which can adversly affect healing or final scar appearance.  In addition, not placing an implant decreases your cost (shorter operative time, no charge for the implants), and gives you piece of mind going forward that you won't need future surgery to correct any problems which could arise with the implants.  Many techniques are used for a breast lift.  The anchor incision is the "Gold Standard" for breast lifting, and is applicable to a wide range of breast shapes and sizes, is safe and time tested.  Done meticulously the incisions should be thin and well camoflouged.  Other techniques should be used especially for smaller breasts.  I hope this helps!

It all depends on your anatomy and you goals, but if you have enough breast tissue to work with, you can usually achieve a very natural result with god shape to the breast without using an implant. An implant will certainly add more upper pole fullness, but there is a cost associated with this, including the potential need for more surgery in the future, so it really depends on your individual anatomy and what look you're attempting to have. In cases like this, a nice compromise is to do the lift first, let things heal and see how you like it. Most of the time patients are quite happy, but on occasion, if a patient wants still more upper pole fullness, than an implant can easily be placed as a second procedure.

Hi there--
With an implant, the upper area of the breast will be full and variably round. Without an implant, and even with a very well done breast lift, the upper pole will be a bit more sloping (as a natural breast is).
I agree with my colleague below that if you think you would be happy without an implant, that that is definitely the way to go. However, I also think that if you think you would be unhappy without upper pole fullness, you would be better served to place an implant. Keep in mind that you can always come back later to place an implant if the initial breast lift doesn't make you happy, but of course this would require a second procedure.
Good luck- I hope you're as happy as you want to be!

The choice of an implant or not is really dependent on what you are looking for. If you want considerable upper pole fullness then you many need an implant. However, if you just want the nipple elevated, then you do not need an implant. In most cases, it is possible to do an internal auto-augmentation with the tissue that is usually resected during the lift. This can help augment the upper pole deficiency. Good luck with your surgery.

Breast lifts without implants are more commonly performed in Europe when compared to the US. Perhaps this is because they are familar with the appearance of a natural breast due to their topless beaches.
In the USA, most patients expect upper breast fullness, similar to the way you appear in a bathing suit. Therefore the vast majority of breast lifts performed here tend to be performed usin breast implants in order to accomplish upper breast fullness in the nude. If this is your goal, then implants are essential. Otherwise there is not need for an implant

There are many different types of breast lift and each one is designed to take care of increasing degrees of breast sagging or ptosis.  Unfortunately there are no short cuts with breast lift surgery.  Many times the patients would prefer a lift with less incisions but it is not always possible.  A plastic surgeon will be able to examine you and select the correct operation to meet your expectations.  In you case with the amount of breast tissue below the inframammary crease you will need at least a vertical mastopexy and possibly an anchor type. If you need more volume then a breast implant will be appropriate.  This will give you the beast result.

I would only add an implant if you want bigger breasts. If you are happy with your size, you can certainly have a lift and get good resuls, including some upper pole fullness.  You probably don't need an "anchor" scar--look for a surgeon who does a lot of short-scar breast lifts.  You should be able to get your results with just a lollipop scar, not an anchor scar.