Does having a lot of thickness in upper pole of breasts mean I will need a bigger size implant fill them?

Thank you for your question and photographs.  I think you are starting from an excellent position and should anticipate a nice result.  Breast implant selection is an exciting, but stressful part of the breast augmentation process as there are so many choices. Unfortunately it is impossible to recommend the best implant style, size or shape without an in-person examination that allows for the measurement of key breast parameters, as well as permits an in-depth discussion as to your desired goals and outcome. I would recommend seeing additional ASPS board certified plastic surgeons to ensure that the implants you decide upon are the right ones to meet your expectations.  It sounds as if it may be wise for you to "try on" several of the implants so that you can have a better visual representation as to what they would look like.  Best wishes! 

Based on your photo it would seem a 350 cc implant would give you a nice result. I'm not sure it would be the D cup you desire, but trying on sizers (as I have my patients do) would help in that decision.  Best of luck to you. 

Having more tissue means you will have a better result with coverage over your implants. No, you don't have to go bigger and stretch out this tissue more. With what you have, 350 should give you a beautiful result.