Currently an E / F cup and hoping to achieve a DD. Can this be done with a lift alone or will I need implants? (photos)

As you are currently breast feeding, it is not possible to accurately answer your question at this time. At your current volume of 32F or 34E your should be able to maintain your desired volume after a lift without the need for implants. Your breasts will however be smaller after you've completed breast feeding and depending on the size at that time, it is possible that an implant would be required to meet your volume goals.

Dear westcoastie,
Thank you for your question. A breast lift does not significantly change the size of your breasts, but you will fit into a bra better after. Breastfeeding will change the size of your breasts, so to get a more accurate idea of size, you would need to be done breastfeeding.
I recommend you see a board-certified plastic surgeon who specializes in breast surgery and breast lifts.

Dear westcoastie,
determining whether you need simply a breast augmentation versus a breast lift can be somewhat complicated. It depends on a number of factors including skin laxity and current nipple position. Generally speaking, if the nipples are lower than the inframammary line the patient will most likely need a breast lift. If the nipples are at or above the inframammary line we can generally get by with just a breast augmentation depending on the size of the implant the patient wants. I often still using implant when I perform a breast lift because it provides more upper breast fullness after the lift. To be sure a consultation with a board-certified plastic surgeon will help determine what the patient actually needs.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Althought it is very difficult to say that without full in person evaluation, it appears that your skin and breast tissue are very loose and streched. Having that in mind, you definitely need reduction and lift; large size breats like D and DD will create bottoming out very soon after surgery due to skin/breast tissue laxity and lack of support. Placing a mash may not be of significant help in that scenario, as well. You may consider more radical reduction and placement of an implant to compensate for breast tissue volume. Considering your small, gracile frame, you should stay withn C/D cup size, at most to have longer lasting result. Hope this helps.

A Breast lift will not fill up the upper pole of the breast. The main reason for a lift is to help give a better shape and achieve some lifting. It will not decrease the size of your breasts. You must wait at least 6 months after breast feeding to have any operation and to best evaluate your breasts at that time.

Thank you for your question. You actually have several options available to you. You can have a standard breast reduction, a breast reduction with a slight modification known as an "autologous implant" in which your tissues are molded to resemble an implant and supported with mesh, and a Reductive Augmentation in which a small implant is placed along with a reduction and lift. I actually published the first paper on Reductive Augmentation in 2017. You are actually an excellent candidate for any of the three operations. It depends on what your aesthetic desires are. Best wishes to you.

The technique I recommend is The Bellesoma Method. This will reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained.

Best Wishes,

Gary Horndeski, M.D.

Thank you for sharing your question and photographs. Nothing replaces an in-person examination, but based on your photographs alone, you will need a lift/reduction in a first stage, heal and then determine if you want implants. This is based on the degree of movement required of your nipple and areola to place it into a more anatomic position. Seek out in-person consultations to get the best advice.

Implants are used to get a larger size and also to create a fuller, rounded breast shape. I think you have enough tissue to achieve the cup size you want, but you still may benefit from an implant to provide more fullness to the upper breast.

Depending on your measurements and the thickness of tissue once you’re done breastfeeding, it may be safest to separate a lift and placement of implants to minimize the risk of damage to the nipple.

A board-certified plastic surgeon is qualified to address your issues. Board-certified plastic surgeons have spent years of training and have the top level of experience and skill. Seek out a board-certified plastic surgeon for your cosmetic needs.