Is it possible to be above D cup and be naturally perky? (Photo)

All breast sizes can be perky or droopy. Intrinsic skin and tissue qualities and how it supports (or fails to do so) the breast volume determines the final shape. On every beach there are beautiful perky "b"'s as well as "d"'s. However simply because a breast is larger or implanted does make it more perky. A consultation with a Board certified Plastic Surgeon will be the best step towards determining what size implant will achieve the most cosmetically attractive result. 3D imaging can also be used to give each client a better idea of what to expect regarding shape and size. As a rule however, mother nature wins. The larger the breast  means more weight. More weight over time taxes the skin and tissues elasticity and eventually gravity wins. (which is why the women you mentioned all eventually had reductions to keep the breasts perky) Add pregnancy or fluctuations in weight and the breasts typically fall faster and farther. 

Hi.  It is certainly possible to achieve larger perky breasts, but there are so many variables that come into play.  During your consultation, you can communicate your desires with your surgeon, and you should definitely bring these pictures to share with your surgeon as well.  That way, he/she can discuss with you about how to go about achieving a similar result.  In general, the larger the breast implant needed to achieve a certain size, the less natural the appearance.  Hopefully that helped a little.  I'm sure it will be more clear when you go for an in-person appointment.  Best of luck!

Thank you for your question and photos. In my practice, I ask patients to communicate their goals with the help of computer imaging and/or goal photographs.  Obviously, the outcome associated with the breast surgery will not necessarily match that of goal photographs perfectly, but they do serve as a better communication tool that subjective terms such as "natural", "proportionate", "voluptuous"… Evaluating goal photographs also allows for a plastic surgeon to determine the consistency of the patient's goals and allows for a discussion of realistic expectations as well.  
***Needless to say, when it comes to achieving patient satisfaction with the outcome of surgery,  it is very important that a patient has consistent goals (fully decided on what she would like to achieve) and a good understanding of realistic expectations (what outcomes can and cannot be achieved).  Generally speaking, the best online advice I can give to ladies who are considering breast augmentation surgery (regarding breast implant size/profile selection) is:
1. Concentrate on choosing your plastic surgeon carefully. Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you are looking for. ***Ask to see lots of examples of his/her work. Sometimes, it is necessary to seek several consultations before you feel comfortable about your choice.
2. Have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining breast implant size/type/profile will most likely help achieve your goals. 
In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “natural” or "D or DD cup” etc means different things to different people and therefore prove unhelpful.
Also, as you know, cup size varies depending on him who makes the bra; therefore, discussing desired cup size may also be inaccurate. Again, best not to discuss your goals and/or judge the outcome of the procedure performed based on achieving a specific cup size. The use of computer imaging may be very helpful during the communication process. The use of in bra sizers may also be helpful. In other words, use as many “visual aids” as possible during the communication process. I encourage patients to meet with me as my times as necessary, to feel comfortable that we are both on the “same page”.
3. Once you feel you have communicated your goals clearly, allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals. Again, in my practice, this decision is usually made during surgery. I generally select appropriate breast implant size/profile after the use of temporary intraoperative sizers and viewing the patient's chest in the upright and supine positions.
 
I hope this helps. Best wishes for an outcome that you will be very pleased with.