I have made the decision to have my breast implants removed. Will I need a lift? (Photo)

Whether to lift breasts at the same time as removal of breast implants is a decision that is best individualized.  Every patient starts out with different anatomy, different goals/expectations, as well as different  preferences.   
In your case, based on the information provided and the photograph, I do not think that breast lifting will be necessary.  However, given the positioning of the breast implants (and the breast asymmetry present), some "adjustments" of the breast implant capsules and/or tissues may be helpful when it comes to achieving improved symmetry after breast implant removal surgery.
 Some general thoughts regarding breast implant removal and the need for breast lifting may be helpful to you:
Generally speaking, what your breasts will look like after explantation depends on several factors such as: the quality of skin elasticity (the better the elasticity the better the skin will bounce back), the size of the implants used (the larger the implant the more trouble you may have with redundant skin), and the amount of breast tissue present at this time (which may have changed since the time of your breast augmentation).
Life experience since your breast augmentation procedure, such as pregnancy or weight gain weight loss, will potentially influence the factors discussed above. If you take these factors into consideration and apply them to your specific circumstances you may get a good idea of what to expect after the implants are removed.
 I have found in my practice, that when breast lifting surgery is definitely going to be necessary in order to achieve an aesthetically pleasing outcome, MOST patients prefer to have the breast lifting performed at the time of breast implant removal.   Most patients simply do not wish to undergo two operations, if avoidable.
   In "borderline" cases where there is doubt whether breast lifting is necessary or not, I advise patients to undergo explantation only and to give their breasts the benefit of the doubt  before deciding whether breast lifting would be beneficial. 
Patience is definitely indicated after removal of breast implants; it will take many months/year for the skin to “bounce back” and for you to see the final appearance of the breasts.
 
 As you can see, there is much to consider (which is why nothing replaces individualized care,  centered on good communication and good judgment, provided by a well experienced board-certified plastic surgeon). 
My best advice: select your plastic surgeon carefully. Make sure that he/she has significant experience achieving the types of outcomes you will be pleased with. Then, communicate your goals carefully, as well. Working together you will come up with a good plan to achieve your goals.  
  Best wishes for an outcome that you will be very pleased with.

Dear Unrelated85,
It is hard to tell for sure how will your breasts look after you remove implants. You can remove the implants and wait some time to see the final shape of your breasts and then decide whether you'll need a breast lift. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery