A properly-performed breast lift only removes an ounce or very slightly more skin, preserving the remaining breast volume (size) in a tightened and lifted skin brassiere. Surgeons who remove breast tissue to replace it with implants are misguided, IMHO. They have apparently been taught that removing breast tissue and then replacing it with implants designed to mimic breast tissue in feel and consistency somehow magically gives more upper pole fullness, or makes a breast lift last longer.Implants add volume, or more size, and a tiny set of risks associated with breast implants. So unless you want larger breasts, you do not "NEED" to have tissue removed and implants placed. You would want implants if your present breast size (minus that ounce or so of excess breast skin per side) is less than your final goal. Bigger CAN be achieved at the time of full breast lift, but only if you don't ask for too much!And yes, your areola size can be preserved, though areolas generally stretch after breast lift, and even more so after breast lift plus implants. Within reason, however, you and your surgeon can decide on the size of areolas that are best for you.If you desire a "look" that is high, round, and "fake" then you should consider a good push-up bra after your surgery. Implants add size, not roundness (unless, of course, you develop capsular contracture--you really don't want this), so if you like your breast size now, find an ABPS-certified plastic surgeon who can remove only skin, preserve your areola size as desired, and lift what you already have into its new position. Then get cute bras for the look you want! Best wishes! Dr. Tholen