Will I need a key hole lift after explant? (photos)

Thank you for the question.  Nothing will replace in-person evaluation when it comes to providing you with good advice.  One way to decide whether or not you will be pleased with the results of breast implant removal surgery alone would be to ask your plastic surgeon to show you photographs of what he/she anticipates your breasts will look like after the procedure.
Generally speaking, what your breasts will look like after explantation depends on several factors such as: the quality of skin elasticity (the better the elasticity the better the skin will bounce back), the size of the implants used (the larger the implant the more trouble you may have with redundant skin), and the amount of breast tissue present at this time (which may have changed since the time of your breast augmentation).
Life experience since your breast augmentation procedure, such as pregnancy or weight gain weight loss, will potentially influence the factors discussed above. If you take these factors into consideration and apply them to your specific circumstances you may get a good idea of what to expect after the implants are removed.
 Patience is definitely indicated after removal of breast implants; it will take many months/year for the skin to “bounce back” and for you to see the final appearance of the breasts.
In "borderline" cases where there is doubt whether breast lifting is necessary or not, I advise patients to undergo explantation only and to give their breasts the benefit of the doubt  before deciding whether breast lifting would be beneficial.  
 I hope this helps. Best wishes.

You have options to consider with your breast implant removal.  You can consider simply having the implants removed and allowing the breasts to heal.  If you are happy with the outcome, then you have saved yourself the breast lift portion.  You also can consider having a lift done at the same time as the removal.  An examination by a board certified plastic surgeon can provide better feedback about the quality and elasticity of your skin and the likelihood that the breasts will retract adequately.

I offer patients with the similar condition combination of the lift and fat grafting. You will need lift because of the areola shape and size. Please see the links for examples