I am a 38DDD, I would like to go to 34D. Would that be appropriate for me? I'm 5'4 152 pounds (Photo)

A real possibility for you. Post your discussions with the PS after being seen so we an have follow up with you. 

Candidates for #BreastReduction surgery are women who wish to have smaller #breasts to achieve a more proportional appearance or to alleviate physical discomfort. Breast reduction can correct symptoms from excessively #largeheavybreasts that may cause the inability to do certain exercises, or create back, shoulder and neck pain, poor posture, bra-strap shoulder indentations and chafing or rashes under the breasts. Women experiencing these discomforts may benefit from Breast Reduction, also called #ReductionMammoplasty. Furthermore, large breasts may interfere with normal daily activities or exercise and will be more comfortable when reduced. Women who feel that their excessive breast size decreases a sense of attractiveness and self-confidence, or results in unwanted attention are also candidates.Large breasts (#macromastia) or #breast hypertrophy can occur in a variety of conditions (family trait, post pregnancy, excessive adolescent growth). In general when the excessive #breast size causes functional problems, insurance will generally pay for the operation if more than 400 – 500 grams are removed from each breast depending on your individual insurance requirements. These problems may include neck pain, back or shoulder pain, hygiene difficulty, and breast pain. Other problems which are less likely to be covered by insurance include skin irritation, skeletal deformity, breathing problems, psychological/emotional problems, and interference with normal daily activities.

Thank you for your question and for sharing your photos. Congratulations on your weight loss!  It must be very gratifying.  You are a good candidate for a breast reduction which includes a lift.  A D cup is a reasonable end point for you.  My only concern at this point is that you may not be an actual DDD even though that is the bra size you wear.  Sometimes when you have a lot of skin laxity, it takes a larger cup size than you actually are to contain the breast tissue.  If your breasts are over-reduced you may end up much smaller than you would like.  You may only need a breast lift to get you to your desired end point.  Many weight loss patients feel that they need a breast reduction, but may be a better candidate for a breast lift.  An in person consultation is required to measure your true cup size and to get a better understanding of how much actual breast tissue you have to better predict your final cup size.  Hope this helps.  All the best!