36 DDD wanting a breast lift, will my size stay the same? Is this a waste of money? (photo)

Thank you for posting a photo. You appear to have significant ptosis, and you would certainly benefit from a lift. Saggy breasts look and feel a lot heavier than the lifted breasts of similar volume. So you are right in avoiding a breast reduction that will likely make you too small. From my experience, I would not expect you to maintain the same bra size of 36DDD after a lift. Even without any breast tissue removal, your lifted breasts will look smaller, better shaped and will likely fit in a smaller bra cup. It is hard to predict the exact size, but this is the general rule.
As far as your back pain is concerned, it is impossible to predict the full impact. Your posture will be better after a lift, and you might see substantial benefits to your back, neck and shoulders but no one can guarantee that. Best wishes!

Hello and thanks for your questions and photos.  After reviewing your description, photos and list of desires, it seems that you would be a fantastic candidate to have a breast lift using the Bellesoma technique. You should not lose any size with this type of lift and will likely even look a bit larger after removal of excess loose skin (same amount of breast tissue - smaller package). This procedure also typically completely relieves all neck, back, and shoulder pain associated with large, "hanging" breasts.  You've provided great information - the only thing that would be more helpful in order to give you the best advice about your options would be an in-person exam.
Bellesoma is a new breast lift technique that seems like it would be a great fit for you, and would improve the appearance of your stretch marks.  This procedure utilizes 3-D volumetric scanning and a multi-point measuring system to design a customized, precise surgical blueprint exactly tailored to your body and the lifted, perky breasts that you desire. The Bellesoma procedure reduces the sagging of your breast, lifts your breast and reduces areola diameter, preserves the nipple sensation and ability to breast feed, and looks as full and perky as if an implant had been placed without using any implant, so no need to compromise.  One of the huge positives of this technique is that there is no vertical incision traveling down the front of your breasts.  If you would like to add more fullness and volume, a natural fat transfer using your own tissue can be performed after your lift to give you the look you're wanting.
Some of the differences between Bellesoma and the traditional breast reduction/lift techniques:
-Bellesoma creates upper pole fullness and projection that traditionally needed an implant to achieve.
-There is NO vertical scar, only well-hidden scars in the fold under the breast, and around the areola.
-The breast is dynamically supported by attaching it to the muscle, so there is no recurrence of sagging which are expected with traditional lifts or reductions.
-The entire central portion of the breast is undisturbed, so nipple sensation remains intact and is very unlikely to be compromised giving the best possible chance for future breast feeding.
-For absolute best results, patients should have a stable weight and have a BMI under 30.
The procedure is accomplished by using the skin of the lower pole of the breast (the part below the nipple that sits in the bra cup) to shape the whole breast into a perky dome, then straps are made of the extra skin, anchoring it to the underlying chest muscle so that there is virtually no chance of repeat sagging.  The skin that above your nipple and below your collar bone is utilized to cover the perky, lifted dome that has been created and then a new (usually smaller) circular opening for the areola is placed at the high point of the cone, creating your new lifted, full and shapely breast.
From your description and photo, you seem to be a very good candidate for this new technique and should really get the look that you are desiring without implants or unnecessary visible scars. I would recommend that you search for an ABPS board certified plastic surgeon who is also a member of the American Society of Plastic Surgeons and the American Society of Aesthetic Plastic Surgeons in your area or an area that you would like to travel to on holiday who offers the Bellesoma technique to discuss your breast lift and possible results.  
Best wishes!Daniel Brown, MD, FACSBoard Certified, American Board of Plastic SurgeryMember, American Society of Aesthetic Plastic SurgeonsMember American Society of  Plastic SurgeonsCastle Connolly Top DocReal Self Top 500

Your breast will be smaller with a lift I recommend you consult with a board certified PS in person for a detailed exam and evaluation.Best wishes.