If you have enough volume, you may be able to avoid an implant

It all depends on your anatomy and you goals, but if you have enough breast tissue to work with, you can usually achieve a very natural result with god shape to the breast without using an implant. An implant will certainly add more upper pole fullness, but there is a cost associated with this, including the potential need for more surgery in the future, so it really depends on your individual anatomy and what look you're attempting to have. In cases like this, a nice compromise is to do the lift first, let things heal and see how you like it. Most of the time patients are quite happy, but on occasion, if a patient wants still more upper pole fullness, than an implant can easily be placed as a second procedure.

At a D cup, you have enough breast volume to work with and create a nice result with a full lift.  The only place you might be lacking is in the upper pole and if you want good fullenss there, you might need an implant.  You can always see what you get without an implant and put one in later if you really need one.

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