There are usually two issues with breasts that look like they have aged – skin excess (which manifests itself as breast droop) and a loss of fullness in the upper breasts. Both need to be considered for optimal breast aesthetics.
In order to regain fullness of the upper breast, an implant will be necessary. Implants will serve to increase the volume of the breast and also create more of a perky look. That may well be the only procedure needed, provided there is minimal droopiness to the breast.
However, if there is sagging, without correcting the droop (i.e. the position of the nipple and areola); breasts can still look old even with their newfound volume. A lift procedure can correct the droop by positioning the breast higher on the chest, which will help to increase the full appearance.
In a consultation I can immediately determine whether or not a lift is needed and just how much of a lift is necessary. I can also determine what incisions would be needed.
All things considered, when the nipples have dropped to a level close to the fold, you should count on a lift being a very strong possibility in order to achieve the best results. Book a consult with a reputable surgeon experienced in breast augmentation and then go from there.
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