32DDD lift and implant or lift and reduction? (photos)

Dear ravenvictoria,based on your photo, it does look like you will need a breast lift with either anchor or lollipop incision. If you want to get perkier breasts then a breast reduction might be an option. If there is enough breast tissue then you won't need implants. I would suggest you to consult a board-certified plastic surgeon.Daniel Barrett, MD, MHA, MS 
Certified, American Board of Plastic Surgery 

Member, Am. Society of Plastic Surgery

Considering your size and amount of sag the best result would be a lift with implants.  Avoiding the lollipop and anchor scars leaves us with no good option for a lift and if you want to avoid those scars, better to do just implants alone and wait to see if you want the scars later.
Again, if there is no vertical scar from areola to inframammary fold (beneath the breast) then the amount of breast tissue hanging below the fold will stay about the same.  The anchor scars can be quite limited if a vertical technique is used but you still need the vertical scar.
Again, you may be happy with implants alone and that's worth consideration if you can tolerate being larger.