Reduction Natural vs Not Perky - how does tissue density determine results?

I’m scheduled for a mommy makeover which includes breast lift with auto augmentation. I’m a DD with a lot of sagging after breast feeding three children. I’m now post menopause and would like to be a perky D. I’ve spoken to four women who have had similar surgeries who are all disappointed that their breasts aren’t perkier. This concerns me and so I’m considering adding a small implant. My mammogram always shows I have very dense tissue and my doctor thinks I will have good results. Does my tissue density mean mine will be heavier/sag or more stable? How can I determine if I should add an Implant?