Based on your photos it does not appear to me that you need a lift.
• A breast implant of any volume will not compensate for a breastlift. If you need a breastlift and your board certified plastic surgeon will be able to tell you this after examining you, a breast augmentation alone will not be satisfactory. Placing a larger breast implant to compensate for not performing the breastlift will make you larger than you may want to be. A larger implant will accelerate the stretching of the skin and put you in the situation where you are in greater need of a breastlift because the sagging will be increased. I have seen many patients who have gone down this road to avoid the breastlift and they are unhappy for a number of reasons and they end up having the lift anyway.
• In my practice, most patients would rather have one operation than two. I tend to perform the augmentation with the breastlift at the same time. Having said that there are many plastic surgeons who, for a variety of reasons, separate the procedures and that is personal preference and comfort level of the surgeon with the procedure. Having the result you are looking for, safely is the goal for the surgeon and it should be for the patient as well.
• You should ask to see before and after photographic results at the office where you are having a consultation. This will give you a good idea about the personal results of your plastic surgeon. Take into account size, shape, nipple position and scar quality. Do not expect your breasts to be perfect after this or any operation. Especially with the augmentation/breastlift a number of issues are being addressed; namely, size, shape and position and size of the nipple and areola. With all those changes there will always be some differences. It is a good idea to ask your surgeon how often a revision is performed to address these differences. The breasts, remember, are naturally different from each other and they will most likely have some differences after surgery as well.
Thank you very much for this question.