Currently a 32 B/C but would like to be around DD. Lift and implants or just implants? (Photos)

Your breasts are asymmetrical in volume, shape and position. At size 32, each 100 cc of implant corresponds to 1 cup size change. To go from a C to a DD would require 200 cc implants so your range between 240cc-300cc implants is good. I recommend a circumareola approach to reposition the nipple-areola complex higher and more medial and allows placement of the implants. I recommend retro-pectoral implants.

Best Wishes,

Gary Horndeski, M.D.

Patient concerns regarding the appearance of their breasts can typically be divided in two pools: volume, ptosis (droop). The procedures to address these issues are as different as the issues themselves. However, these concerns are not mutually exclusive. Many patients, whether they are aware or not, will benefit from both.
There are two factors which can help to answer the question of which surgery will deliver the most satisfying result: mastopexy, augmentation or both. Patients must first consider the position of the NAC (nipple areolar complex i.e. the pigmented portion of the breast) as it relates to the inframammary crease. If the nipples are at or below the level of the crease the patient may benefit from a lift or mastopexy. The breast lift is designed to elevate sagging breasts to a more youthful position. It also helps to reshape and tighten the skin of the breasts. This is typically accomplished via a periareolar (around the nipple) incision with or without a vertical incision.
Mastopexy is an effective way to address sagging breast, however, the changes which accompany weight loss or pregnancy can also decrease volume of the breasts. When a woman wants the volume restored, or increased, a breast augmentation will also be needed in conjunction with mastopexy. Augmentation can help restore the volume loss which is well known to women following children. There are a number of options available to women considering augmentation ranging from size and implant type to access incision.
A breast augmentation alone may also be appropriate if ptosis is mild. If the patient is comfortable with the natural appearance of the breasts but desires them to be larger, a breast augmentation alone is the right procedure. Augmenting significantly ptotic or sagging breasts tends to magnify the problem. In these cases, a mastopexy performed in conjunction with an augmentation is preferred.
Based on your photos, your nipple position does not demonstrate an absolute need for lift. Nipple areolar complex position is preserved. The left side has some pseudoptosis. You would likely benefit from an augmentation. That being said, there is no substitute for an in person exam.
There is a procedure for every problem. To determine which technique is right for you, consult with a board certified plastic surgeon Patient should discuss their concerns with their physicians in order to make an educated decision

From the posted photos it appears you have asymmetry in volume and nipple position. In order to correct that a lift would be needed. If you do not have a lift and use differently sized implants the volume asymmetry may be improved but the nipple position will remain.