This is difficult to answer without a thorough conversation with a plastic surgeon. I tend to ask my patients if they have the volume that they want when wearing a non-padded bra. If the answer is yes, then they likely do not need an implant and instead they need a breast lift to raise the nipple and reshape the breast. That being said, if the patient wants upper pole fullness, then they may need a breast implant or the addition of fat grafting to the upper pole of the breast. A mastopexy alone will raise the nipple and improve the shape of the breasts but will not give upper pole fullness. A consultation with a plastic surgeon is recommended to determine the proper surgery to address your concerns and your expectations.