Natural-feeling breast enhancement
It sounds like you would benefit from a mastopexy or breast lift. Hopefully, lifting your breasts will still leave you with a cup size that you like. If not, then you could also undergo augmentation at the time of mastopexy.
A mastopexy will "feel" normal since it is your own tissue without an implant. If a small implant is placed at the time of lift, the "feel" would probably also be fine. It is when large implants are placed in patients with very little breast tissue that both appearance and feel are compromised.
It is important that you sit down with an experienced plastic surgeon who will make measurements and then make recommendations unique to you and your body. I recommend that you see several surgeons and choose the one you are most comfortable with.
Breasts and lack of fullness
If you do not have a lot of fullness, you may need an implant. Some women fill the cup but are really mostly skin.. An exam would be helpful.
Natural Breast Implant Results for Breasts Lacking Fullness?
Placing large breast implants in large breasts may be more prone to revision surgery due to changes in the brest independient from the implant over time as well as the inevitablity of ptosis with time.. In order to ahcieve upper fullness subgalndular placement may be preferable but this may increase the potential for ptosis. . This is a difficult problem for which some surgeons are using tat to selectively augment the upper poriton of the breast.
Natural Breast Enhancement
With a 32D bra size, I would have to agree that you have " a lot of tissue to work with." The basic question you need to ask yourself is, Do I want bigger breasts (more volume) or do I want to reposition them in an upward direction?" If you want more volume, then an implant is a necessary part of the plan. If you are mainly interested in an upward shift in the breast profile, then a mastopexy would be the appropriate recommendation.
It is true that an implant and a mastopexy would provide the greatest possible increase in fullness in the upper portion of your breast. However, this combination of procedures would be the most expensive option and would have the highest complication rate. In the final analysis, you would need to see a Plastic Surgeon to determine which of these options would best accomplish your desires, based on the particular physical characteristics of your breasts
Natural breasts with an implant
Based on your description and desires, there may be several options available to achieve natural looking full breasts. It is important to consult with a board certified plastic surgeon to determine what variables he/she must take into account to determine which option would work best for you. The variables to consider would include: how much laxity your breast skin has, how large you would like your breasts to be and how much droop your breasts have. Based on these findings, the options available to help restore breast fullnes, while maintaining a natural look, would include: a breast augmentation, a breast lift, a breast augmentation with a lift. If a breast augmentation is an option, I would recommend silicone implants as they tend to look and feel more natural than saline implants.
Can breast implants feel natural?
It is very important that you visit with a responsible and board certified plastic surgeon, as there are several variables that would affect how this question is answered, including the relative importance to you of upper pole fulness, maintaining the breast size you have now or increasing the size, improving the nipple position, and several others...
In general, it is impossible to achieve real upper pole breast fulness without an implant.
With good technique and a modern silicone gel implant, your breasts CAN achieve a very natural look and feel.
Here's some advice on how to best find a surgeon you like and can trust:
There really is no way to add fullness without adding an implant. However, these days silicone implants placed under the muscle can give a very natural result. Unnatural results occur when people try to put implants that are too big or to wide for the patient.
Breast implants for fullness
If you are a "D" already, as you mentioned and your breast is "puddling in a bra"...you might be a candidate for a breast lift instead.
An implant can certainly increase fullness, but you need to be examined to give better advice.
Breast implants can help upper breast fullness
You may be able to achieve upper breast fullness with an implant. The more natural breast tissue that you have to begin with will determine the "naturalness" in the feeling of your breasts post-operatively.
This will also depend on which type of implant you select, with silicone implants having a more natural feel.
The third factor is whether the implant is placed over or under your pec muscle. This would be determined at your consultation with an appropriate examination.
Women often elect to have an implant placed at the time of a breast lift to give the breast a proper "upper pole fill," or rather improvement in the fullness.