Patients want the lift, but don’t want the scars. Based upon your pics, I would agree with the other PS here: you can pass with implants alone, but you are BETTER off with the lift.
If you like the “hang” and don’t care so much that the nipple is pointing down, you can have just the implants for now.
You can always opt for a lift in the future. You don’t burn any bridges by staging your procedure.
It will simply take two procedures vs. one. (Bennett Yang, MD, Rockville Plastic Surgeon)
Implants with lift
You could certainly have implants placed and not have a lift, however the contour of your breasts may be less than ideal.
On the other hand, with a lift (mastopexy), in exchange for better contour, you will have much more scar on your breast. A good option to consider is to have the implants placed first. If you are not happy with the contour of your breasts, you could always have the lift done later. (Jonathan C. Weinrach, MD, FACS, Scottsdale Plastic Surgeon)
Breast lift with augmentation
Scarring is always a concern for women who want a breast lift (mastopexy). Based on the photos you submitted; a mastopexy along with breast augmentation would be recommended to provide the best aesthetic result. Most women feel that having perkier, better positioned breasts is a good trade for the mastopexy scars. I suggest you consult with a board certified plastic surgeon who will outline the location of the breast lift incisions before making a decision. (Richard A. D’Amico, MD, FACS, Englewood Plastic Surgeon)
Do I need a breast lift and /or just implants?
After reviewing your photos it appears that you would need a lifting along with breast implants to get you the best result possible. If you do either just implants or just a breast lift you would be compromising the result.
You shoud consult with a Board Certified plastic surgeon and have your breasts examined in order to fully discuss with you the options that you may have and examine before and after photos. (George Lefkovits, MD, New York Plastic Surgeon)
Breast Implants and Lift
I think almost all plastic surgeons would recommend a breast lift with the breast implants from the photos presented. However, I may feel different after an exam, discussion of implant size, and determination of goals. (Kenneth B. Hughes, MD, Los Angeles Plastic Surgeon)
Silicone Implants but No Breast Lift
Without knowing more about your specific desires, I think breast implants without a lift will not give a good result. I would suggest a breast lift with small implants at the same time or later as a staged procedure. (Karol A. Gutowski, MD, FACS, Chicago Plastic Surgeon)
It’s a mistake to not get a lift when you need one.
I think it would be a mistake to not do a lift. Implants alone will not lift your breasts, they will likely create a snoopy nose deformity as mentioned in another surgeon’s reply, they will only make your large areolae larger, and they will not help your asymmetry.
A lift (likely vertical lift) with implants will give you a better more youthful shape, make your areolae more proportionate with your breasts, and improve your asymmetry. Yes, the downside is you’ll have a lollipop shaped scar, which usually doesn’t bother patients after several months of healing and fading. (Douglas J. Mackenzie, MD, Santa Barbara Plastic Surgeon)
Is my Ptosis Bad Enough to Not Recommend Implants Without a Lift?
I would not recommend implants if you were not willing to have a lift should you need one. I think the chances are high that you would have an unsatisfying outcome, with your own breast tissue draping off the implants. If that occurs, your choices would be to live with that unsatisfying appearance have a lift remove the implants.
Based only on the photos, I think my predicted outcome is high enough that I would suggest not having the implants unless you were willing to follow up in three months with a lift should you agree that the outcome is not what you want. (Jourdan Gottlieb, MD, Seattle Plastic Surgeon)