If you have larger, droopy breasts, check to see whether your areola is below the breast fold. If so, you have what is classified as grade 3 ptosis. Some helpful links:

• Breast Ptosis: Degrees of Breast Sag, Do You Need a Breast Lift?
• Breast Lift - Mastopexy Information
• Breast Lift for Sagging Breasts
• Breast Mastopexy
• Ptosis - What is it?
• Google search for "fascial suspension mastopexy"
• Google search for "grade 3" ptosis

If you fall into this category, there's an excellent chance the surgeon will tell you that he will need to do a breast lift, either as part of the breast augmentation surgery, or as a separate surgery prior to the BA. He will (or should) clearly tell you that the risk of not getting a lift means a pretty good likelihood that you'll end up with perky breasts where the implants are, but droopy breast tissue hanging from them (ie, not an aesthetically pleasing look). If you think you can convince him not to do the lift in this case, good luck with that. Remember, these surgeons have aesthetics to consider, and would be hard pressed to proceed with something that runs contrary to their training and experience.

Note that with a 'lollipop', vertical or anchor lift, you will end up with a vertical scar down the front of the breast (from the bottom of the areola to the breast fold); there's no way around this, unfortunately. However, some clinics offer micropigmentation treatments (essentially tattooing) and other options for minimizing the resulting scar.