You are interested in a breast reduction and hope to have perky breasts, similar to your breasts before pregnancies and nursing. First, let's address the timing of such surgery with your intended weight loss. It's always better to try to achieve your realistic weight first, since the size and shape of your breasts may change with weight loss, and you would prefer that change occurs before surgery so those changes can be incorporated into the surgical plan.
Second, breast reduction obviously reduces the size of the breasts, but it also lifts the breasts to a more anatomical position, as well as reshaping them. The problem is, is that there are no "support structures" in the breast such as bone or cartilage that will hold the breasts in that exact shape and position. Even if reduced breasts look "great" on the OR table, they will not stay that way. There will be early settling and slight sagging and loss of upper pole fullness, despite the technique chosen. In the long term, aging, gravity , loss of elasticity, weight fluctuations, pregnancy, nursing, and hormonal changes will also have an effect on the appearance of the breasts. If you desire "perky", usually this implies upper pole fullness, and the only way to achieve this is placement of an implant. The more your breast volume is implant compared to natural breast tissue, the less sagging will occur and the more perky the breasts will appear. For patients that have moderately large breasts that desire smaller breasts but with upper pole fullness, I usually recommend staged surgery to prevent vascular compromise and to improve predictability....Stage 1 is the breast reduction/lift, and usually 3 months later, Stage 2 is the breast augmentation. Good results can be achieved. Good Luck! jkrmd