The combination of breast lift/reduction operations is on the top of the list of operations in aesthetic surgery accompanied most commonly by complications.  Therefore, your plastic surgeon will try to avoid placing an implant at the same time.  Depending on the characteristics of your particular breasts, as a result of a reduction and/or lift (without an implant) you may end up not only with a pleasing appearance, but also with sufficient breast firmness.  When more projection and firmness would be desirable, an augmentation in a separate operation may be the most prudent way to proceed.  As in any aesthetic surgery, there are exceptions to the above, based on findings that can properly be determined only through an in person examination by a board certified plastic surgeon.  I hope this is informative.