I’m 18 and size 40DD and they are far apart. I want them symmetrical and lifted but I really do not want implants. (photo)

I think you could achieve a nice result with a breast reduction. Your right breast appears to be a bit larger than your left. A breast reduction will help achieve symmetry by reducing the larger breast more. A breast reduction will also improve your overall breast shape and lift the breasts, as a breast lift is a part of breast reduction surgery. I recommend setting up a consultation with a board certified plastic surgeon with experience in breast reduction. Good luck with your procedure.

Hello and thanks for your questions. After reviewing your description, it seems that you would be a good candidate to have a breast lift using the Bellesoma technique.    Photos and a more complete description would be helpful in order to give you the best advice about your options.  If you would like more fullness and volume, a natural fat transfer using your own tissue can be performed after your lift.  The best way to avoid problems with the nipple-areoala is to search for and choose a surgeon who has a tremendous amount of experience with breast lifts.
Bellesoma is a new breast lift technique that seems like it would be a great fit for you.  This procedure utilizes 3-D volumetric scanning and a multi-point measuring system to design a customized, precise surgical blueprint exactly tailored to your body and the lifted, perky breasts that you desire. The Bellesoma procedure reduces the sagging of your breast, lifts your breast and reduces areola diameter, preserves the nipple sensation and ability to breast feed, and looks as full and perky as if an implant had been placed without using any implant, so no need to compromise.  One of the huge positives of this technique is that there is no vertical incision traveling down the front of your breasts.  If you would like to add more fullness and volume, a natural fat transfer using your own tissue can be performed after your lift to give you the look you're wanting.
Some of the differences between Bellesoma and the traditional breast reduction/lift techniques:
-Bellesoma creates upper pole fullness and projection that traditionally needed an implant to achieve.
-There is NO vertical scar, only well-hidden scars in the fold under the breast, and around the areola.
-The breast is dynamically supported by attaching it to the muscle, so there is no recurrence of sagging which are expected with traditional lifts or reductions.
-The entire central portion of the breast is undisturbed, so nipple sensation remains intact and is very unlikely to be compromised giving the best possible chance for future breast feeding.
-For absolute best results, patients should have a stable weight and have a BMI under 30.
The procedure is accomplished by using the skin of the lower pole of the breast (the part below the nipple that sits in the bra cup) to shape the whole breast into a perky dome, then straps are made of the extra skin, anchoring it to the underlying chest muscle so that there is virtually no chance of repeat sagging.  The skin that above your nipple and below your collar bone is utilized to cover the perky, lifted dome that has been created and then a new (usually smaller) circular opening for the areola is placed at the high point of the cone, creating your new lifted, full and shapely breast.
From your description and photo, you seem to be a very good candidate for this new technique and should really get the look that you are desiring without implants or unnecessary visible scars. I would recommend that you search for an ABPS board certified plastic surgeon who is also a member of the American Society of Plastic Surgeons and the American Society of Aesthetic Plastic Surgeons in your area or an area that you would like to travel to on holiday who offers the Bellesoma technique to discuss your breast lift and possible results.
Best wishes!Daniel Brown, MD, FACSBoard Certified, American Board of Plastic SurgeryMember, American Society of Aesthetic Plastic SurgeonsMember American Society of  Plastic SurgeonsCastle Connolly Top DocReal Self Top 500

Hello and thank you for posting photos along with your question. From your photos it appears you would likely benefit not only from a lift but also a slight reduction on the left and a larger reduction on the right to try and achieve better symmetry between the breasts. This will also likely improve back and neck pain, if present, that is caused from the weight of the breasts. I don't think you would need an implant because you appear to have dense breasts tissue. Hope this helps and wish you the best of luck!