42N or 42O cup size. I'd like to know which procedure would be best: a breast reduction and lift, or a breast reduction? (Photo)

if you want smaller breasts then you should have a breast reduction. Lifting of the breast is part of the breast reduction operation and is not a separate procedure. If you do not want your breasts smaller then you could have just a breast lift which would elevate and reshape your breasts, but make no smaller. Discuss that with your plastic surgeon and they will explain and show photos of how you might look post op. They can also help you decide lift or reduction. Good luck.

When a breast reduction is perform there is also a lift.  If you wanted a lift at the current size, it would be impossible without doing a reduction.  So you would need a reduction/lift.

I have performed breast lifts and reductions on
women larger than you.At size 42 each
300 grams removal corresponds to 1 cup size change.If you want to go down to size H, 1,800 grams
removal from each side would be required.I recommend a new technique called The Ultimate Breast Reduction™.The breast tissue is reshaped creating upper
pole fullness, elevated higher on the chest wall and more medial to increase
your cleavage.The weight of the breast
is transferred to the underlying muscle resulting in immediate pain relief
without excessive reduction.This
technique avoids the ugly vertical scars of the traditional technique,
maintains nipple sensation and the ability to breast feed.Best Wishes,Gary Horndeski, M.D.