Would I keep my size 38D with a lift and a 450cc saline implant? (Photo)

There is no way to guarantee a particular bra size. Bra sizing varies greatly between bra manufacturers and a C in one bra will be a D in another. What matters more than the assigned bra size is the way the implant looks on you. The best option for your body and aesthetic goals can be determined in a thorough implant sizing session.Implant sizing depends on several factors. One of the most important factors is your breast width. Generally, your surgeon will measure your breast width, and then provide you with a range of implant sizes appropriate for your native breast size. There are more nuances to it than just what I've described, but this approach works for most women.I usually have my patients bring in a large bra and a tight t-shirt to do sizing. I'll then choose 3-4 implants that I feel are appropriate, and have my patients place them in the bra under the tight t-shirt. My patients can then look in the mirror and get a good sense of what they will look like with the provided implant sizes. My patients like this approach and get a great idea of how they will look.By using this technique, your surgeon can outline a range of appropriate implant sizes that will be aesthetically pleasing, and you make the final decision.I hope this helps. Good luck!

Thank you very much for your question and your
photographs.Unfortunately, it is very
difficult to answer your question given the photographs included.That being said, it is important to realize
that bra cup sizes are relative and differ by manufacturer.A C cup at Victoria’s secret is typically closer to a B
cup at Nordstrom’s or Macy’s.Furthermore, it is impossible to state that a certain size implant will
increase an individual’s bra cup size by certain amount.I wish you the best of luck.

Thank you for your question and photos.  As long as you have chosen a surgeon who is board certified in plastic surgery and has expertise in the breast lift procedure, you should trust his opinion since he has also physically evaluated you.All the best,Dr. ResultsMiami, FL

Without photos of your breast- and the benefit of physical exam- it is difficult to comment accurately. Generally speaking, after multiple pregnancies , and 38D- current size-- I think you might be a good candidate for a breast lift only- without implants. Best, to seek an experienced Board Certified PS for in person consultation. 

The breasts may lose their
elasticity and firmness which can be caused by different factors such as
pregnancy, massive weight loss, lactation and aging. To reaffirm the breasts
and restore the natural look your surgeon can perform a mastopexy or breast
lift. A breast lift restores a firmer, perkier, and more
aesthetically pleasing shape to sagging breasts. This not only can improve
a patient’s appearance by restoring her youthful, feminine proportions,
but also help bras and swimsuits fit more comfortably and attractively. By
removing excess, stretched out skin, reshaping the breast tissue, and raising
the nipple & areola into a more forward position, a cosmetic surgeon can create
a more youthful breast contour. Stretched, large areolae can also be
reduced during breast lift surgery, creating an overall better proportioned,
natural looking breast, Actually the perkiness on a person or another, depends
on patients skin and breast tissuefor the first 3 to 4
months until your implants have settle in. I recommend you to wait and keep
using your post surgical bra, that will help you with the shape and support!!

I think you want to be big so I would do you in 2 stages ie the first would be the lift and not make it too tight because we will go back and put in a big implant.consider it.

You issue is breast size. If only doing a lift than you should stay the same size. If doing reduction/lift than small implant only to be able to close the vertical incisions. Otherwise have the lift surgery first, heal for 3 months than consider a larger implant. BTW the posted photos of NO help...need unclothed posted photos. 

Thank you for the question and pictures. Ultimately, you will do well spending additional time with your plastic surgeon communicating your goals, questions, and concerns. In other words, careful measurements, dimensional planning, and careful communication will be key.

Generally speaking, patients undergoing this combination operation should understand that it is significantly more complex than breast augmentation surgery only and that it is associated with a significantly higher risk of complications and need for additional surgery. Breast lifting involves some removal of breast skin envelope; there may be limits as to how large of a breast implant can be utilized safely.
Generally speaking, the best online advice I can give to ladies who are considering breast augmentation/lifting 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.

2. Again, have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining which operation and/or 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 “keep my current size” or "D cup" etc means different things to different people and therefore prove unhelpful.
Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup size may also be inaccurate. The use of computer imaging may be very helpful during this communication phase.

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. The use of temporary intraoperative sizers with the patient in the upright position makes selection of the best breast implant size/profile relatively easy.
I hope this, and the attached link, helps. Best wishes.

Your photos are of no help in answering your question.  Breast lift surgery will reshape the breast for a perky look, and implants add volume.  If you are happy with your breast volume, you will not need implants.