I want to get saline implants. I'm a saggy 38D wanna go to perky DD.

Far more important than the technique is the skill and experience of your plastic surgeon. Choose your surgeon rather than the technique and let them explain why one technique may be better than another. See the below link on some suggestions on finding the most qualified Plastic Surgeon for a  Breast Augmentation

Hi MszDiamond,

Determining whether you need simply a breast implant versus a breast lift or both can be somewhat complicated. It depends on a number of factors including skin laxity and current nipple position.

Generally speaking, if the nipples are lower than the inframammary line the patient will most likely need a breast lift. If the nipples are at or above the inframammary line we can generally get by with just breast augmentation depending on the size of the implant the patient wants. I often use an implant when I perform a breast lift because it provides more upper breast fullness after the lift. Also, price range for breast lift is around 10k to 15k depending on whether you need a lollipop or a donut mastopexy.

Another important consideration to make would be the breast implant type and sizing selection. In fact, this is a complicated process and requires a detailed consultation that includes a discussion of your goals, a detailed examination, and a lengthy discussion. But the decision will always start and end with the patient. 

When it comes to sizing, we have all of our patients find 3 photos of their desired breast size. We ask for naked breast photos because clothing can obscure the true size (push up bras). Next, we consult with patients and go over the photos and take detailed breast measurements during a physical exam. Next, we using a sizing algorithm to determine a range of implants that will work based on the exam and the measurements.

Lastly, during the operation, we use silicone sizers in the operating room to see how the size actually looks in the breast. We sit the patient up in the operating room, while asleep of course, and compare the sizer result with their desired look photos. If it is too small, we start the process over with a slightly larger implant. We don't stop until we get the perfect match.

Of all of my breast augmentation patients, every one of them has been happy with their size due to this detailed and meticulous process. You don't want to invest time and money into a result that is either too big or too small.

You should discuss your concerns with a board-certified plastic surgeon and make sure that your surgeon understands your goals.

Daniel Barrett, MD, MHA, MS

Certified, American Board of Plastic Surgery 

Member, Am. Society of Plastic Surgery

Having not seen you, I would still guess that you most likely need a breast augmentation AND a breast lift (mastopexy). The augmentation will increase your cup size, namely going from the D to DD-cup. The mastopexy will address the saggy appearance. 
These procedures can and are often done at the same time. Combining the two is helpful from a cost reduction and total recovery time standpoint. 
I would advise meeting with a board certified plastic surgeon so that you can discuss your goals. Having a physical exam will be most helpful for the surgeon to determine optimal implant size and type of lift, if any, that is indicated. 
Best of luck!