Excellent question and a very common concern. The decision on whether or not to have implants placed at the time of your breast lift can be made by considering the following questions:1) When your breasts are placed in a bra (not a "push-up" or padded bra), are you happy with the size of your breasts? If so, then a breast lift (mastopexy) is likely to be the option that is most suitable as you don't need more volume to your breasts, you just need the volume that you have placed back into a more youthful position. A breast lift alone in this circumstance will most definitely provide you the most natural look, because it is completely natural.2) If you desire more volume than what you currently have or as you stated, you want more "upper pole" fullness, then a breast lift combined with an implant (augmentation-mastopexy) is the best option for you as this will simultaneously provide more volume and upper pole fullness than a breast lift alone. However, some consider upper pole fullness to be an "unnatural" look. I'd argue that a well performed augmentation-mastopexy will provide a very natural look that would fool even the most discerning eye. In my practice, I ask my pre-operative breast patients to show me photos of breasts that represent the look they're trying to achieve. In my experience, these photos are almost always breasts that have been augmented with implants, but my patients cannot tell. The patient almost always assumes that their chosen photos show natural breasts.So, several questions outlined above for you to consider. In the meantime, locate a reputable, Plastic Surgeon, Board Certified by the American Board of Plastic Surgery and schedule a consultation. The surgeon can speak with you in more detail about your personal aesthetic desires and how to best achieve these goals. Spend time making a thoughtful, well informed decision up front and you'll be thrilled with your results no matter which way you choose to go. Always happy to help!Best of Luck!