After an examination, your surgeon will be able to tell you if a lift can be done at the same time of the removal, or if it needs to be staged. If you have minimal breast tissue, especially around the areola, most would recommend staging the lift to avoid any possible loss of the areola. The lift could possibly cut away the majority of blood flow to the nipple if you have little breast tissue.
Thank you for your post. These are tough cases for any plastic surgeon. Removal of the implants will lead to obvious skin sagging, in addition to what you have now. The skin needs to be removed and tightened, and nipple elevated to better position (mastopexy). We always have concerns about the circulation/blood supply to the skin edges and nipple when doing this procedure. However, I think with simple implant removal, you will very unhappy with that appearance. I think a breast lift should be considered at the same operation. Best wishes.