32DDD lift and implant or lift and reduction? (photos)

Hello Ravenvictoria,
Thanks for your questions and photos. After reviewing your photos and wish photos, I don't think that you need any implants at all to achieve a fantastic result with just a lift.  You do seem to have a moderate amount of ptosis or sag in both breasts - your nipples appear to be sitting a bit below the fold under your breast. There is a new breast lift technique called Bellesoma that seems like it should be a great fit for you. The Bellesoma procedure lifts your breast, preserves the nipple sensation, 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. 
Some of the differences between Bellesoma and the traditional breast lift techniques:
-Bellesoma creates upper pole fullness 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.
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 photos and wish photos, you appear 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 who offers the Bellesoma technique to discuss your breast lift
Best wishes!
Dr. Brown

Thank you for your pictures and questions. My first comment is that every single one of your wish pictures shows someone in a push-up bra or some type of support device so none of those people look like that without clothes. So right out of the gate, you need to check your expectations because neither will you after surgery. Second, while you (and everyone else) would like to avoid scars with surgery, to get optimal results you are going to need at least a lollipop scar or perhaps even an anchor scar to get appropriate lifting. I would actually advise you consider doing your surgery in two stages. Get the lift and let that heal completely. Then size yourself for an implant to be placed 3-6 months later. I think this approach gives you the best chance of the outcome you are looking for.Hope this helps!

Yes, you will benefit from a lift and an implant.  The implant selection should be based on a combination of your desired size, soft tissue dynamics, breast base diameter and skin elasticity.  I recommend an in-office examination as well as a detailed discussion with a surgeon who you are comfortable with.   Finally, make sure your surgeon is a Double-Board Certified Plastic Surgeon certified by the American Board of Plastic Surgery (ABPS), a member of the American Society of Plastic Surgery (ASPS) and the American Society of Aesthetic Plastic Surgery (ASAPS).Best,Dr. DesaiBeverly Hills Institute for Aesthetic Plastic SurgeryHarvard Educated, Beverly Hills & Miami Beach Trained, Double-Board Certified Plastic Surgeon