Breast lift and augmentation is the way to go.
You will not likely be happy with your results if you do not have a lift of some sort done, if not in the short term, in the long run.
Your areolar complexes will be covering a very large surface area of your breasts and you will eventually develop a “rock in a sock” with above muscle large implants.
Please listen to the advice of your Plastic Surgeon and obtain a second opinion if you are not satisfied with that. (Kenneth R. Francis, MD, FACS, Manhattan Plastic Surgeon)
I Want Breast Aug, but I Dont a Lift. Can I Still Go Under the Muscle?
As long as you fully understand the potential results than yes haste only an implant of a large size, 600 cc. (Darryl J. Blinski, MD, Miami Plastic Surgeon)
Lift vs Augment
Unfortunately if the nipple is a bit low and you only have an augmentation , then you can get an odd appearance with the implant sitting high and the breast sitting low. We like to avoid lifts when we can due to the extra scarring , but the scarring may look better than an odd-shaped breast. (Terrence Scamp, MBBS, FRACS, Gold Coast Plastic Surgeon)
Breast augmentation with a lift
I would recommend having a mastopexy (lift) at the same time as the augmentation. Without a lift the breasts would not be an attractive shape. A lift would also have the advantage of reducing the size of the areola (Simon Overstall, MBBS, FRACS, Melbourne Plastic Surgeon)
Regardless of whether you choose a subglandular or a submuscular breast augmentation, I don’t think you will be happy with the shape or position of the breasts without some type of breast lift (donut, lollipop, or anchor). Implants do make the breast larger, but they really don’t raise the breasts or nipples significantly. (Vincent D. Lepore, MD, Manhattan Plastic Surgeon)
If your nipples are a bit low, a circumareola lift with implants can be nice. It is best to be examined in person to figure out the best procedure. (Steven Wallach, MD, Beverly Hills Plastic Surgeon)
I Want Breast augmentation without lift . Can I Still Go Under the Muscle?
Breast implants belong behind the muscle, period! Placing implants over the muscle in hopes of correcting moderate ptosis (sagging) which is what you have, has a high likelihood of resulting in “bottoming out”, meaning that the breast tissue will not be able to support the weight of the implants and the implants will work their way down, resulting in an excessively long inframammary segment and hollowness at the top.
The only way to avoid this is to always place the implants behind the muscle. In your situation, from your photos it shows you primarily need a peri-areolar mastopexy or commonly know as “donut lift”. Adding an implant will give you more fullness if you so desire. But with your height and weight I thing DD is too large, of course it depends on where you buy your bras, because for example a DD at Victoria’s Secret would be D or even a full C at Macy’s. (Ruben B. Abrams, MD, FACS, Manhattan Plastic Surgeon)
Circum-Areolar Mastopexy with Implants Possible
Accounting for the difficulty in assessing your breasts from the photographs provided, the best option for you is implants placed under the muscle with a cirucm-areolar breast lift. You will get fuller, perkier breasts with minimal scarring! This is especially true because you want to go with relatively large implants that will assist with the overall “lifting”of your breasts. AVOID putting the implants above the muscle at all cost! (Eric Sadeh, MD, Albuquerque Plastic Surgeon)
Breast augmentation without a lift will not work long term
The easy thing is to tell you what you want to hear. I do not believe you will get a good long term result with just a breast augmentation. Breast augmentation alone may give you a good result, but only for a year or so. Your photos suggest that the breast, skin and areola are too stretched and positioned too low. As others have said, an implant placed to match the position of your breast will have the effect of creating a larger, droopy breast. It is unlikely to create a lifted and larger breast in the long run. Lifting the breast at a later date can be complicated, and expensive, especially if the implant was placed very low to begin with. It might be best to seek several consultations. (Michael S. Hopkins, MD, Sydney Plastic Surgeon)
Implant but no lift: probably not a nice result regardless where the implant is placed.
It is certainly possible to put implants under the muscle in your case but I really doubt you would like the result without an uplift. The pre-stretched breast will continue to slide down over the implant and there is a significant likelihood that within months the nipple/areolar complex will be pointing downward, with the prominence of the implant sitting much higher. Even with the implant size needed to shift you to a DD, it looks as though you will still have a bigger skin and breast envellope. I think this is the main issue – whether the implant is above OR below the muscle. So, you can get to a DD and look nice but not without a lift. (Adrian Knox, MBBS, FRACS, )