I want a Breast Reduction from 32G to 32C/D. Is it better to remove as much tissue as possible and then go with an implant?

Since
you have more tissue than you desire, implants are not required.To change from a 32 G to a 32 D would require
300 grams removed.Women undergo breast
augmentation after breast reduction because of the lack of upper pole
fullness.For that reason, a new
technique wall developed called The Ultimate Breast ReductionTM.Your breast tissue is reshaped creating upper
pole fullness, elevated higher on the chest wall and more medial to increase
your cleavage.This is done without the
ugly vertical scars of the traditional technique, maintains nipple sensation
and the ability to breast feed.The
disadvantages of the Wise pattern (developed in 1956) are the lack of upper
pole fullness, nipple numbness, the inability to breast feed and the ugly
vertical scars.Using newer technology
it is possible avoids implants altogether.Best Wishes,Gary Horndeski, M.D.

I would not recommend a radical reduction.  Radical reduction has a higher chance of poor healing and poor outcome.  An implant is not a safety net for a reduction.  Allow your surgeon to perform the appropriate reduction for the best long term outcome.

Thank you for your question.  It sounds like your best option would be a breast reduction.  I recommend you schedule an in person consultation where you can be examined and then have the options explained.

A breast reduction is meant to decrease volume of the breast tissue.  Its added benefit is a lift as breast tissue is removed as well as skin.  A breast lift does not usually remove  much breast tissue, and does not significantly change the size or the weight of the breast.  Personally I would not recommend removing tissue only to replace it with an implant.  Implants are not meant to last forever, and most people do not require a second reduction in their life, unless their weight significantly changes.  You do not list your age, but you should anticipate implants to require another procedure in about 10 years.  I think your odds of preventing future breast surgeries are better with a regular reduction and no implant, than to remove too much and replace it with an implant.

Your question is very insightful. I'm not sure what you mean by "radical resection" . What about the nipple?  I like Dr. Seckel's idea. Why not just start with a regular reduction and see how it goes?