Should I do a lift? (Photo)

No, you will just have larger and still sagging breasts because of having such a large and heavy implant. You would do much better with a lift and smaller implants placed behind the muscle for support and upper breast fullness. What minimal lift you will get in the beginning will not last. Go back and talk to your surgeon.

I think most people would be extremely disappointed getting an augmentation and no lift, according to your photographs. The expectation should be that your nipples won't change position much. They may even become lower. You look like an excellent candidate for breast augmentation with lift, which would also be able to decrease the width of your areola, if you desired.

Dear kelly4546,
based on your photos, you look like a good candidate for breast lift. My preferred lift is a lollipop lift when a periareolar won't do (ie greater than 2cm lift required). The lollipop technique was created by a Canadian plastic surgeon named Elizabeth Hall-Findley and treats the breast as a three dimensional structure instead of two dimensions (anchor - lift). Most importantly it does not require the horizontal component scars that the anchor-lift requires and breasts appear much more natural, lifted, and less boxy. Lastly, the lift lasts longer because the lollipop doesn't rely on the skin to hold the breast up, its actually breast tissue thats being brought together to support the breast and hence improves longevity.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery