Will a Breast Lift and Reduction Be Enough to Keep Breasts Up and Perky?

In my opinion you should start with a breast reduction/lift  to get the breasts where you want them on the chest wall. This operation will serve to remove excess skin, breast tissue, and adipose tissue. A second stage breast augmentation procedure may or may not be of interest to you;  this will increase superior pole volume/fullness.

Of course, direct physical examination and a review of your goals will be necessary to give you precise advice.

Best wishes.

There are risks to agressive reductions. However, in order to achieve the look you have described, it would best be achieved with an agressive reduction and implants. This would NOT be my advice.

The quick answer is that all you need is a reduction.  A breast reduction moves the nipple to a higher and more youthfull position, removes the excess breast tissue and results in an overall more youthful "perkier" appearance.