Do I need a breast lift or just augmentation?

I believe that you could get a good
result with breast implants alone. An augmentation can oftentimes give you the illusion
of a lift. After a minimum of 9 months, when the implant has settled, you'll
have a better idea whether or not you think your breasts are perky enough. You
can always get a lift later if needed. For more information on this and
similar topics, I recommend a plastic surgery Q&A book like "The Scoop
On Breasts: A Plastic Surgeon Busts the Myths."

It is very difficult to give good advice based on the single photograph, with your arms elevated. I would suggest that you submit frontal and side view photographs with your arms by your side for accurate assessment and advice. Having said that, based on the photograph, it is my best assessment that breast lifting will also be helpful in achieving the best outcome possible. Ultimately you will do best seeking consultation with board-certified plastic surgeons who can demonstrate significant experience in achieving the types of outcomes you will be pleased with. Then, communicate your goals carefully as well. I look forward to reviewing your next post if you so choose. Best wishes.