Can I get a breast lift without implants if I'm happy with the size but want perkier breasts?

You only get implants if you want to be larger. Period.
I don't know who it was...but someone started telling patients that they needed to get an implant to get a nice result wtih a lift. Rubbish! In fact, it is better to avoid implants if having a lift.
By definition, any patient needing a lift has skin that has already failed to hold up the existing weight of their breast. Adding weight to that makes no sense. Sure, you have removed skin, but the skin that remains is the same skin that gave way once already.
But for you, who doesn't even want to look any larger, for sure you don't need implants.

Yes, you can absolutely get a breast lift (mastopexy) without implants if you are happy with the size of your breasts but want them to appear perkier. A breast lift focuses on repositioning and reshaping the existing breast tissue, removing excess skin, and tightening the surrounding tissue to lift the breasts and restore a more youthful contour. It can also reposition the nipples and areolae for a more youthful appearance.
This procedure will not increase breast volume, but it will improve the firmness and shape of your breasts, giving them a lifted and more youthful look. If you are content with your breast size and only want a perkier appearance, a breast lift alone is often the best option.
It's important to consult with an experienced plastic surgeon to discuss your goals and ensure you're a good candidate for the procedure. In some cases, if there is a slight loss of volume in the upper part of the breasts, the surgeon may recommend a fat transfer or a small reduction of tissue, but implants are not necessary if you are happy with the size.
Krishna Vyas, MD, PhD, MHSHarvard, Hopkins, & Mayo Clinic Trained Aesthetic Plastic SurgeonNew York, New York

Implants can be very useful in creating architecture and projection, improving asymmetry, and adding extra volume to small or lax breasts that have been depleted by nursing or changes related to weight loss or aging. If you are already happy with your current breast volume adding weight with implants will only defeat the purpose of trying to make them more lifted or perky with a mastopexy. You would be best served by having a mastopexy (or breast lift). If there is a little too much tissue a very small reduction of tissue along with reshaping of the breast with mastopexy will give a very natural and uplifted result. A small deficiency of volume in the upper pole can be corrected with fat transfer and mastopexy. This has the added benefit of liposuction of stubborn areas of fat in the abdomen, flanks and thighs as donor sites for fat (preferred sources for fat transfer).

Absolutely, if you're happy with the size of your breasts but want them to appear perkier, a breast lift (mastopexy) can be an excellent option. This procedure focuses on lifting and reshaping the breast tissue by removing excess skin and tightening the surrounding tissue to support a new, more youthful breast contour. The nipples and areolae can also be repositioned or resized to better match the newly shaped breasts. A breast lift doesn't increase the size of the breasts; rather, it aims to improve their position and firmness, providing a more lifted, rejuvenated appearance. It's an effective solution for those who are satisfied with their breast volume but seek enhancement in terms of lift and shape due to sagging or changes following pregnancy, breastfeeding, or weight fluctuations.

An uplift operation is performed when the patient is happy with the breast volume and the tissues need lifting to bring nipple areola to better position and remove excess skin. Certain techniques can produce a perkier results with uplift where an internal lift can achieve such results. Normally implants are needed to give upper pole fullness. Internal lift can give some fullness in upper pole without adding any implants.

Thank you for your question. Absolutely, an implant is only used to increase the size of the breast.

Dear Realself user,This is a very good question.When your breasts are full but not perky it is indeed possible to shape them nicely and perky without putting implants and I always prefer doing that with my patients when I know that what we have is enough to work with, but when I don't think the breast is full enough to make it perky without implants I would have to put implants to get the result the patient wishes for.Best of luck.
TAS Aesthetic Surgery Clinic

Thank you for your question. Patients can certainly undergo a breast lift, or mastopexy, without also having breast implants placed. In fact, most of my patients do: the combined augmentation/mastopexy is less common than the breast lift. Breast lift surgery is highly effective at raising the breast mound. Technically speaking, I solely raise the breast mound in a lift without removing breast tissue, whereas in a breast reduction, breast tissue is also removed to decrease the size of the breasts.I would urge you to visit a board-certified plastic surgeon experienced in cosmetic surgery of the breast and body for this operation. There is a significant aesthetic difference in the outcome of a high quality breast lift versus a mediocre one.

Thank you for your question.  Photos would be helpful to best answer your question.  A breast lift to bring the breasts up and reduce the size of the areola.  The type of incision needed is best determined by physical exam.I perform a liposuction breast lift/reduction known as Breast LipoLift®. This specialized technique spares more nerves and blood supply as well as removes tissue from the areas you don't want such as near the armpit and the lower portion hanging near your stomach. Once I use this to shape the breast, I then remove the excess skin to tighten the breast and create a more proportional silhouette with better cleavage. This procedure is also more accurate than traditional breast lifts or reductions since I use 3D measurements to uncover size asymmetries. During the procedure I remove exactly whatever is more from the larger side to get as close to symmetry as possible. Since I perform this less invasively the recovery time is faster and drains are not necessary. Over 90% of my patients are out to dinner the next evening taking only Advil and Tylenol if even needed. The size would depend on the proportion with your body versus going for a cup size.  It has been proven to have less complications than traditional breast reduction (please see my Breast LipoLift® page web page) and should not affect nipple sensation, mammograms, cancer risk or breast-feeding. The best way to assess and give true advice would be an in-person exam.  Please see a board-certified plastic surgeon that specializes in breast plastic surgery.  Best of luck!    Dr. Schwartz Board Certified Plastic Surgeon#RealSelf100Surgeon #RealSelfCORESurgeon#RealSelfTopContributor

Yes!  This is achieved by carrying out a breast lift surgery called a ‘mastopexy’. There are a number of ways this can be carried out depending on your own anatomy.  The various techniques include a variety of scars.  Patients with good shape to their breasts who just want their nipples positioned a little higher with a small degree of skin tightening are appropriate for breast lifts that just leave scars around the areola.  Most patients that want more of an uplift need to accept longer scars as the trade off to achieve this.  These scars usually involve a vertical scar from the lowest part of the areola through the central part of the lower breast down to the inframammary crease below the breast.  Many surgeons also prefer to put a horizontal scar within this crease as well to further improve the shape.  The other main trade off is nipple sensation which is variable depending on the technique used and how much lift is required.  It is also possible to further improve results with lipofilling where liposuction from other areas is then treated to optimise the fat before re-injecting it into the breasts and improve breast lift results further without the need for silicone implants.

Great question, but not an easy answer. If the quality of the breast tissue and skin envelope is good and if there is minimal sag, then a breast lift alone can give you your ideal result: full, rounded breast mound with the nipple/areolar complex at the apex of the mound.
However, if the skin laxity is of such degree that the nipple is below, the breast crease, then a combination of the breast lift and submuscular implants will give you the ideal result. 
Make sure you don't put an oversized implant in to give you your lift alone. It all depends on the quality of the breast tissue itself and the skin envelope that will decide the best surgical approach.