Thanks for your question and congratulations on your pregnancy. Your plan for your breasts sounds reasonable. You should wait for your milk to dry up and be at your steady weight prior to surgery. I suggest you meet with a reputable Board Certified Plastic Surgeon for an exam and consultation to go over your particular goals. Good luck!
The combination of exchanging implants to a smaller size and doing a lift is commonly done. You will of course need to wait until the appropriate time, after breast feeding and any changes your breasts undergo as a result of your pregnancy.
In many cases implant exchange can be safely combined with a breast lift procedure. However, there are several factors that may impact that decision: the degree of sagging, the thickness of the breast tissue, whether the current implants are above or below the muscle, and a patients smoking history. I recommend seeing a couple of board certified plastic surgeons several months after you deliver. Allow your breasts to return to baseline then the surgeons can truly assess the likelihood of combining the procedures.
Thank you for the question. Practices will vary. I can tell you that in my practice, the operation you are considering can usually be done in one stage. There are occasional cases however where I have specific concerns, for example regarding blood supply to nipple/areola or surrounding tissues, where I will recommend a two-staged approach. Much depends on the degree of breast ptosis ( "sagging"), the quality of the overlying skin/tissues, and the size of the breasts patient wishes to achieve with the revisionary breast surgery. Generally, if in doubt regarding the safety of the combination procedure, best to proceed in a staged fashion.
My best suggestion: select your plastic surgeon carefully. Make sure that he/she has significant experience achieving the types of outcomes you will be pleased with. Working together you will come up with a plan to achieve an outcome that you will be pleased with. Best wishes.