I want a Breast Reduction from 32G to 32C/D. Is it better to remove as much tissue as possible and then go with an implant?

Since
you have more tissue than you desire, implants are not required.To change from a 32 G to a 32 D would require
300 grams removed.Women undergo breast
augmentation after breast reduction because of the lack of upper pole
fullness.For that reason, a new
technique wall developed called The Ultimate Breast ReductionTM.Your breast tissue is reshaped creating upper
pole fullness, elevated higher on the chest wall and more medial to increase
your cleavage.This is done without the
ugly vertical scars of the traditional technique, maintains nipple sensation
and the ability to breast feed.The
disadvantages of the Wise pattern (developed in 1956) are the lack of upper
pole fullness, nipple numbness, the inability to breast feed and the ugly
vertical scars.Using newer technology
it is possible avoids implants altogether.Best Wishes,Gary Horndeski, M.D.

I would not recommend a radical reduction.  Radical reduction has a higher chance of poor healing and poor outcome.  An implant is not a safety net for a reduction.  Allow your surgeon to perform the appropriate reduction for the best long term outcome.

Thank you for your question.  There are so many advantages to having your own breast tissue rather than an artificial breast implant, that I would strongly recommend you have a breast reduction and first see how you'll look.  Please choose a very talented board certified plastic surgeon who has a lot of experience in aesthetic breast surgery.  A properly performed breast reduction should give you a beautifully shaped breast that will not need an implant.