I've had 2 children. My breasts are really small and they droop a little. I want to...
As your breasts only "droop a little," it is quite possible that you may not need a lift at the same time. Often after having children, the breast may lose some volume or the skin may have stretched. Frequently, an implant alone will fill up the skin envelope and improve small amounts of "droop" without the need for the added incisions of a lift. Each patient however is different, and your plastic surgeon will advise you after an examination. Thank you for your question.
Quite a number of the breast augmentation patients in my Raleigh, NC plastic surgery practice are moms. After one or more pregnancies, most women experience a loss of breast volume combined with some 'stretching out' of the breast skin. In many of these patients, a breast implant of moderate size will restore a very pleasing breast contour. These patients are not looking to raise eyebrows at work or around the neighborhood - they just want to throw their padded bras away, to have more options with clothing, and to feel better about their appearance in private.
When there is mild to moderate laxity of breast skin and/or loss of breast volume that makes the breasts appear somewhat droopy or 'deflated', the addition of a breast implant can 'fill up' the excess skin and create the appearance of a breast lift (although this is not truly a breast lift or 'mastopexy'). This situation often exists after pregnancy and lactation, but there are also quite a number of patients with significant breast skin laxity who have never been pregnant.
In patients with more advanced drooping of the breasts, particularly when the nipples are pointing downwards instead of slightly upwards, a mastopexy (breast lift) needs to be combined with the breast augmentation surgery to tighten the skin envelope around the implants, in order to produce a result that is truly youthful and aesthetically ideal. This procedure is called an augmentation mastopexy, and the results of this operation can be dramatic and absolutely transforming. An augmentation mastopexy is required when the surgeon's preoperative assessment is that without a lift, the likely postoperative appearance is that of a breast drooping off of an implant - which is a distinctly unnatural and unappealing breast profile.
If you have significant sagging or breast ptosis then a breast lift in addition to a breast augmentation may be required.
One simple test you may do at home is called the pencil test. Simply lift your breast place a pencil in the fold beneath your breast, dropped the breast and if the pencil stays pressed against your chest then you'll likely have significant breast ptosis and may need a breast lift.
Most importantly consult a board certified plastic surgeon who is a member of the ASAPS and has an excellent reputation in your community for a consultation.