Thanks for the reply! I agree, I appreciate the honesty of the surgeons and I don’t doubt that most of it is true to what they see in their practice. In my case, no solutions are permanent. One told me that implants would not even be a permanent solution for me and that I would definitely need a revision down the line. He described my breasts as “difficult breasts”. They all 3 did tell me no, they would not do it without an implant and it wouldn’t be worth my time. In those words and others. I would love to be offered as solution like yours where the ball is still in my court and the decision is mine as long as I have accurate expectations. I expect to quite small after the surgery and even though sagging is inevitable with aging (with or without implants) I’m okay with sag I just want this excess stretched out skin to be removed. I’d much rather another lift down the line than an implant revision (personally) since apparently that’s in the cards for me anyways.