What is breast lifting? Combo with or without augmentation
Active lifestyle and implants
If you do not want an implant do not get one. You are correct you will be smaller than you are now when you get a lifting and it will involve both a vertical and possible small horizontal component.
In terms of implants and an active lifestyle, in particularly running, I have countless patients who are avid runners who have had breast augmentation and are happy. Please seek the opinion of a board certified plastic surgeon in your area. (Vishnu Rumalla, MD, Dallas Plastic Surgeon)
Active and Happy with Size = Breast lifting
A mastopexy or a breast lifting, will decrease your current cup size by about one half, which conveniently is the size you wish to be (full B).
Implants will give fullness in the upper breast but will add to the volume and the weight of the chest which will impact with your active lifestyle.
The scars of the mastopexy are the only downside given your anatomy and your desires for the result. (Christopher J. Schaffer, MD, Birmingham Plastic Surgeon)
Breast lifting alone vs. lifting and implants
It appears that a lifting alone will get you the shape you desire. If you are happy with your current breast size then I would proceed with a lifting alone. You can always have an augmentation down the road if you decide you want more volume. I would definitely consult with an ASPS member in your area to discuss your options further. (Gregory Baum, MD, Syracuse Plastic Surgeon)
Breast lifting alone or augmentation too
I think you could go either way on this. Many patients are under the misconception that they MUST have breast implants inserted when a lifting (mastopexy) is done. This is simply not so. It all comes down to whether or not you are happy with your size. If you are, and simply want to address the sagging, go with a mastopexy alone.
Only excess skin will be removed, and volume will be essentially the same. In fact, some patients look bigger because the breast tissue is higher and there is better projection. On the other hand, if you want more volume, go with a combination or staged procedure. (Robert Stroup, Jr., MD, FACS, Cleveland Plastic Surgeon)
Your dilemma is a common one and in my practice I would likely offer you a breast lifting with either autologous fat transfer (fat injection) to fill the upper pole or Strattice and not implants as you seem content with your size. (Kevin Tehrani, MD, FACS, New York Plastic Surgeon)
If you are very active, try the lifting first.
I would suggest that you discuss a breast lifting to restore your breast form with your plastic surgeon. You should end up a perkier 34C.
In athletic patients, it probably is better to err on the conservative side with regard to enlargements. Adding an implant may make you larger than you would be happy or comfortable with.
You can always go back later for implants if you sense the need to be larger. (Douglas J. Raskin, MD, DMD, Colorado Springs Plastic Surgeon)
Breast lifting without Implants
If you are currently the size you like in a bra, then all you need for breast rejuvenation is a mastopexy (lifting). This will lift your breasts and make them more perky but will not decrease the size.
You will remain the same size and continue to wear the same size bra (if by the same company). (Robert T. Buchanan, MD, Highlands Plastic Surgeon)
Treatment of drooping breasts often requires adjustment of surface area and volume
If you undergo breast lifting alone, you will not have sufficient volume in the upper pole. I you undergo augmentation alone, you will require a giant implant to fully fill out the skin envelope without having the appearance of a Snoopy breast, where the nipple and areola droop off the end of the breast. The answer is to solve the balance of the breast volume and surface area with a combined procedure of breast lifting with implants. It is not necessary to separate the steps as it can be done as one procedure. It will achieve an appropriate volume with the proper positioning of the nipple, and it gives the opportunity to decrease the size of the areola. (John Cassel, MD, Miami Plastic Surgeon)
Breast lifting with oe without augmentation
It’s important to realize that a breast lifting will not reduce the size of the breast, but rather reshape and elevate the lower breast tissue and nipple position.
If you are reasonably happy with your volume, it may be reasonable to have a lifting alone and after approximately six months proceed with an augmentation if the size and or superior fullness is not enough. (David A. Bottger, MD, Philadelphia Plastic Surgeon)