Is it possible to go from 40D to 36C with just a breast lift, or do I need to combine it with a reduction? (Photo)

Thanks for your picture. To get the most optimal result I think that you need a breast reduction. This will take out enough tissue to reduce the weight of the breasts, increase shape and help with the lift of your breasts. Good luck

A breast lift with small reduction would be a reasonable option
just based upon your picture, but an exam will be necessary to make a
determination. Find an expert in breast surgery in your
area who has great reviews and great before and after photos.Kenneth Hughes, MDLos Angeles, CA

With resupport of the breast by mastopexy, onlly a small amount of breast tissue may need to be removed, but removed nonetheless.

All reductions should lift your breasts - you do not need to pay extra for the two procedures.All lifts do not reduce the breasts.Anytime you change cup size you need to change breast volume - so a reduction is in order for you.If you would like more information on this, please read my book "Cosmetic Breast Surgery - a complete guide from A to double D".

Yopu could have an assymetrical breastlift/reduction to achive the size you wnat.This is often done at the same time. as an outpatient.

Thank you for the question and picture. I would suggest that you seek consultation with board-certified plastic surgeons who can demonstrate  significant experience achieving the types of outcomes you would be pleased with. Then, communicate your goals carefully. This, in my opinion is best done in front of a full-length mirror and with the help of goal pictures.  Communicating goals carefully with your plastic surgeon will allow you both to come up with the best plan to achieve your goals.  Do not base your communication on achieving a specific cup size, as this form of communication can be a source of confusion. Breast lifting and/or a small breast reduction may be indicated, based on your description of current situation and goals. You may also find the attached link, dedicated to breast lifting concerns, helpful to you as you learn more. Best wishes.

If you are wanting to go down in size, you will need to consider a breast lift with a reduction in volume.  

You really need to fully understand terms! A LIFT is only elevation of the N/A and tightening the breast without fat or gland removal. Thus a true lift CAN NOT make the breast smaller. A LIFT/REDUCTION is a lifting plus small amounts of breast tissue and fat removed. This might be your answer, but doubtful. A REDUCTION/LIFT is the lifting with a moderate to large amount of tissue removed. This is what I think you would need to go from 40D to 36C... Best to seek IN PERSON Opinions. 

In your case, to archieve go from 40 D to 36 C, the ideal is combine a breast lift with a removal a small amount of glandular tissue . With this we can achieve a smaller breast and more beautiful breast. 

A breast lift will change the shape of your breasts.  A breast reduction will make them smaller.  I suggest you see a local plastic surgeon who can examine you and recommend a treatment plan.   Good luck.