Do I need a breast lift?
This is an individual choice. You would end up with higher more perky breasts with a small reduction/lift. You could nurse and have children without a problem most likely. The trade off would be the presence of scars, which fade over time, but are visible.
Speak to a board certified plastic surgeon with experience in breast reduction surgery. (William B. Rosenblatt, MD, New York Plastic Surgeon)
When a good portion of the breast tissue is below your breast crease then it is generally advisable to perform a lift to achieve the optimal result. I would not recommend augmentation alone based on your photos.
Obviously, scar placement and healing are concerns for patients considering a breast lift.
However, I have found that patients heal very nicely from these incisions, and I frequently review photos of similar patients that are 6 months to 1 year post surgery. In most cases patients are surprised at how good the lift patients look, and the incisions are often not very visible.
A thorough consultation with a board certified plastic surgeon is very important, and will help you make a good decision. (Steven M. Camp, MD, Fort Worth Plastic Surgeon)
Breast work
Any surgery or decision you make on your body should be because you want to do it. If you are happy with your figure and shape then you do not need any cosmetic surgery. If you feel that you want your breasts lifted because you are unhappy with the drooping of them, then I think that’s reasonable based on the pictures.
Scars fade and smaller incisions can be used for you. You should never have cosmetic surgery because someone else. However I do feel that significant others and spouses should be supportive before cosmetic surgey. One should never hide it from their spouse. (Matthew G. Stanwix, MD, Richmond Plastic Surgeon)
Breast lift or augmentation.
It would appear that you would benefit from a breast lift. This would give you more firmness and elevation to the breast overall. Scars will always be present, but they do fade after 1 year and should not distract from the good results that you should expect to see. I would candidly ignore opinions of friends and loved ones, because if you are bothered by the shape of the breasts they should accept and be supportive of your decision. Continue to follow the advice of your Plastic Surgeon in this regard. (Francis (Frank) William Rieger, MD, Tampa Plastic Surgeon)
It is my impression from your pictures that you are more DD than G, but that can be easily confirmed by measurements of your chest and breasts circumference. You have severe breasts ptosis ( droopiness ) and if you like them to be perky , breast implants will not do it, moreover they most likely will aggrevate it. The only option to achieve that goal is a lift procedure. There are different techniques and my prefered one is the key hole method. In your case, because of the large size, I would recommend also breasts reduction for better and more durable result. As far as the scars, for those of my patients who had the surgery it is not an issue. For those of my patients who refused the scars the result was less than optimal in my opinion. With time the scars mature and become much less noticable while the beatiful breast remain with you for a long time. Always, consult with board certified plastic surgeons and check their before and after pictures to make sure that you like the results. (Shlomo Widder, MD, McLean Plastic Surgeon)
I suggest you talk to a lot of people before making any decision. To address your questions. You do not need implants. If you want a lift to reduce sagging, most likely removing breast tissue to make the breast smaller will be necessary, otherwise your breasts will sag again. Having children can effect the results.
Be careful moving foward if your significant other has serious concerns. Some patients feel much better about their appearance after a lift and the scar quality can be good.A board certified plastic surgeon can you gather more information and advice specific to your situation. (Tracy Pfeifer, MD, Manhattan Plastic Surgeon)
If you are happy with your cup size and shape in a bra, then a breast lift or mastopexy is the procedure of choice for you. The trade off is scars, but there are no long term maintainance issues that exist with implants.
If you desire an increase in cup size, then volume has to be added with implants or fat grafting. (Christopher J. Kovanda, MD, Minneapolis Plastic Surgeon)