Achieving Upper Pole Fullness Possible with Smaller Breast Implants?

A breast lift, mastopexy, will probably make your breasts appear smaller because of the tighter skin envelope. Although your breast tissue will be lifted by removing the excess skin (mastopexy), the size of your breast will remain constant. Upper pole fullness would be extremely difficult to achieve with just a mastopexy because the size of the breast has not changed.
However, breast augmentation with mastopexy is a tricky operation and has a high documented complication rate. The safest approach in my opinion would be to stage your procedure and do the breast lift first and then come back later and do the augmentation. This will give you the opportunity to see how you like the shape of your breasts after the mastopexy and allow the incisions to heal before subjecting them to the added pressure of an augmentation.

Without an exam it is hard to say what would be best for you to create  the look you want. This is something  reviewed in person.