Currently a natural 32DD but looking for more "upper pole". Do I need a lift and implant, or just high profile implant? (photos)

Hello and thank you for your question.  The
best advice you can receive is from an in-person consultation.  With that
being said, based on your photographs, the best shape and contour could be
achieved with an implant alone without need for a breast lift.  Make sure you specifically look
at before and after pictures of real patients who have had this surgery
performed by your surgeon and evaluate their results.   The most
important aspect is to find a surgeon you are comfortable with. I recommend
that you seek consultation with a qualified board-certified plastic surgeon who
can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Hello and thanks for this question. I don't believe you need a breast lift, but this must be confirmed with an in-person examination. Most likely, you will need round breast implants the are of the appropriate diameter to deliver enough silicone into the upper pole of the breasts. So that gravity does not drop the breast implant overtime, I would highly consider using textured breast implants.
Best wishes, Dr. ALDO :)

You have very nice natural breasts.  Adding an implant is possible to enhance the upper pole and they will also make your breasts larger.