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

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 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.

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.