Hello back to you! A picture speaks a thousand words....your photo indicates your nipple level is well below your infra-mammary fold (IMF) level. As plastic surgeons, we know that the surgical treatment of that problem is NOT an implant, but a lift. An implant alone, no matter how large, will result in a deformity called "double bubble'' or "Snoopy nose", i.e., you will have the mound of the implant where the breast should be positioned, and your own natural breast tissue will appear to be hanging off the implant....VERY UGLY! Sometimes we can "get away" with placing a large implant for a slightly sagging breast (i.e., the nipple is either at or slightly below the IMF), but we lower the level of the current IMF so that the implant can be positioned lower, allowing for the mound of the implant to be more under the mound of the slightly drooping breast....this gives the "illusion" that the breast has been lifted, but in actuality, it has not.
A lift alone will result in a better positioned breast, but it will not give you the upper pole fullness that it appears you desire. Furthermore, even if you had a lift alone, since you have a moderate amount of breast volume already, the weight of your natural tissue will likely result in faster drooping of the breast. In cases such as yours, one that has a low nipple level and moderately sized breasts, I usually recommend to consider a small reduction (which simultaneously lifts the remaining breast tissue) and an implant to provide upper pole fullness and a more "perky" look. The result is likely to last longer because more of the breast volume is from implant and less from your own natural breast, which will sag over time. Sometimes I suggest these 2 procedures be performed in stages, but that would be up for discussion between the patient and the surgeon (staged procedures increase predictability of the end result). Regardless, I know this is not what you wanted to hear, but I think you would be sorely disappointed in the end result if you underwent implant only, regardless of size/projection/etc. Good Luck!