Breast Implant Exchange. Do I Need a Lift? (photo)

I currently have saline 375cc. BA done 10 yrs ago. The doctor that did them said he could place a larger implant in, remove some tissue so that the implant drops lower in the breast, and make my nipples appear more in the middle of my breast instead of their current placement, at the bottom. I would like to go with a 500cc implant. Do you think I could achieve good results without a lift? I really dont like the breast lift scars, but if that's my only option, then so be it. Thank you