I used to be a 32A. 335 on the left and 355 on the right, I am now a 32D. Should I get implant exchange and fat graft? (Photos)

Thank you for your question. You are lucky that you have attractive breast as they are. If you want more cleavage, then I would perform a internal bra/capsulorrhaphy procedure. I wrote the very first paper on how to do this in 1999. I have been in practice for over 30 years and revisionary breast surgery is a large part of my practice. I do not think that fat grafting will be of any benefit. Best wishes to you.

Dear Dreamygal,
Thanks for posting your pictures, though seeing the before pictures would be helpful. From observing your pictures you appear to be asymmetrical in regard to breasts size. Right breast is noticeably larger than left breast by maybe half size. You will have to be measured to ascertain that you are 32 D cup size, because the different photos reveal different impressions. If indeed you are 32 D cup size and you want to be symmetrical 32DD you will have to change the implants to 475 cc on the right and 525 cc on the left. In regard to the wide cleavage, it is not because of your anatomy, but rather because the medial muscle was not dissected enough towards the midline. So you will need medial capsulotomy (scar release) to get nice cleavage and you will need also superior capsulotomy to accommodate the larger implants and get nice upper slope. To achieve it the best approach is via sub areola incision.
Always, consult with experienced board certified plastic surgeons who operate in accredited surgery center for your safety. Most importantly, check the before and after pictures in the photo gallery to make sure that they are numerous, consistent and attractive with nice cleavage, symmetrical, nice projection and natural looking.
Best of luck,
Dr Widder
widderplasticsurgery.com

Based on your nicely post of photos, I agree you could have an implant exchange to 450 to 500 cc range high profile implants with fat grafting after Lipo to correct issues in your breast. Expect fees to range from $8000-$15,000. Best of virtual consultant with.