If you are happy with a B cup breast size, then just a lift should give you enough volume.
Mostly skin excision with preservation of breast tissue should result in the size you desire. (N. Bill Aydin, MD, Paramus Plastic Surgeon)
Breast lift procedures / augmentation
A hands on evaluation with your plastic surgeon is a must for you. With your volume of tissue, a lift would give a very good result.
Cup sizing is very in-exact with breast surgery. From your letter I Infer that small, but full is your preference (your comment about full B).
Adding an implant would give fullness. You would need a augmentation reduction. I reiterate an examination by your plastic surgeon and discussion between the two of you to explore your options is necessary. (James R. Benjamin, MD, Bowie Plastic Surgeon)
Breast lift for sure
I would recommend a skin tightening procedure such as a breast lift at least. A small implant may help as well. You can always do that procedure separately. (Timothy Fee, MD, Jacksonville Plastic Surgeon)
Breast Lift procedures plus Implants Best Option For C Cup
Because of the amount of sagging that you have I would recommend a breast lift procedures because placing implants alone will increase the amount of sag that you have and could interfere with your ability to run comfortably. A breast lift will improve the position of your nipple and breast but also allow for the placement of implant so that you can achieve a B cup breast which you are looking for.
A breast lift alone will not give you the fullness and firmness that you want. Be certain to consult a plastic surgeon who is certified by the American Board of Plastic Surgery and experienced in breast lift and breast augmentation surgery. (Brooke R. Seckel, MD, FACS, Boston Plastic Surgeon)
Breast Lift procedures / augmentation, or Just a Lift?
It appears that you will definitely need a breast lift regardless of your final decision on size. I would not recommend an augmentation alone as you will just have heavier, sagging breasts. If you do a lift alone, your volume will seem smaller even if no tissue is removed, but this may be adequate for you if you don’t want large breast.
A board-certified plastic surgeon should be able to tell you approximately what size you would be after seeing you in person. If this is not large enough, an implant can be added to achieve your desired size. If you are having a lift and augmentation, you can really choose your breast size within reason(meaning not going too large). (Donald Griffin, MD, Nashville Plastic Surgeon)
Just a lift
With a lift only you can stay a C cup or smaller and be perky and a bit firmer. The best part is if you decide down the road you want implants you can do that as well. Most of the time I remove a bit of the lower tissue with the procedure to try to create more longevity of the result. (Gregory Lynam, MD, Richmond Plastic Surgeon)
Breast surgery for a runner
If you truely want a B cup size then a lift is all that is required. Must women desire some fullness so an implant plus a lift is needed and this is what I would recommend (Earl Stephenson, Jr., MD, DDS, Atlanta Plastic Surgeon)
I would expect you to have a 1/2 cup to full cup size decrease in size after a breast lift. This is because the loose glandular tissue will be more compact as the skin envelope is tightened. I do think you can get a full B cup result without implants using an auto-augmentation technique, where the glandular tissue of the lower half of your breast is redistributed to the upper breast recreating cleavage and upper pole fullness.
I would recommend an in office exam with a board certified plastic surgeon to discuss whether the addition of a small implant would be helpful in achieving your goals. (Paul S. Gill, MD, Houston Plastic Surgeon)