Hello!The position of the nipple height is in a quite a good position (not pointing down) so it's a little bit hard to recommend a lift without completely seeing the texture and quality of skin. Generally if the nipple is below the breast fold then a lift may be required to achieve higher placement of the nipple and therefore a more youthful look.Sometimes a lift can be avoided with a larger implant or an anatomical shaped implant - but best to speak the surgeon about these options following a thorough analysis of your medical history and a thorough clinical consultation.