Which procedure recommended for 34DDD with sagging? I am considering lift & reduction, but seek dr input re implants? (Photo)

You look like a perfect candidate for a reduction with a lift.  It sounds like an implant would not be a good fit for your goals.

   A breast reduction with lift would seem reasonable given the pictures.Kenneth Hughes, MDLos Angeles, CA

Based on your photos and what you desire from surgery, you would benefit from a breast reduction and not implants.  This operation also involves a lift.  There is no way to do this operation without scars, typically around the areola and down the front of the breast.  You would have to decide whether or not they are minimal enough for you to accept. 

I recommended reduction mammaplasty, or breast reduction. This includes a lift, and a good plastic surgeon will put more volume at the top of breast where you need it. Don't ever add an implant unless you need it for size. It will need to be changed over your lifetime, increases the cost of surgery, and you have plenty of you own volume- just needs to be put in the right place!!

If your desire is to have smaller breasts, then breast augmentation with implants may be unnecessary. Since you have a lot of your own natural tissue a breast reduction combined with a breast lift can give you a beautiful result. Based on your photographs I think you would be a great candidate for a short scar breast reduction/breast lift. This would leave you with the lollipop scar.  This technique illiminates the scar in the fold of the breast.I always believe that if you have enough of your own natural breast tissue it is better to avoid an implant and the complications associated with breast augmentation. 

Thank you for the question and pictures. Although it is difficult to give you precise advice (this would require in person consultation, and a full communication of goals, options, risks/complications, timing...) based on the photographs and stated goals, I think that you will benefit from breast lifting/reduction surgery.  These operations do involve removal of skin to “tighten” the breast skin envelope and raise the breasts' position on the patient's chest wall. With this skin excision,  there is some scarring present postoperatively. For some patients the necessity of  scars associated with breast lifting is a “dealbreaker” ; for these patients it is better to avoid breast surgery altogether.
 On the other hand, many patients (If properly selected and who are doing the operations at the right time of their lives  psychosocially) accept the scars associated with breast augmentation/breast lifting surgery as long as they are happy with the improvement in contour, size, and symmetry. This acceptance of the scars is the essential “trade-off” associated with many of the procedures we do in the field of plastic surgery.  When the time is right, seek consultation with board-certified plastic surgeons. Ask to see lots of examples of their work, communicate your goals clearly, and learn about the pros/cons/risks/complications associated with surgical options. Best wishes.

Thank you for your photos and question and you would benefit from a small reduction that is associated with a lift utilizing a minimal scar techniqueDr Corbin

The final decision needs to be made with your board certified plastic surgeon after an in person consultation and discussion of your goals, risks, benefits, etc. However, in general, an augment, or implant, is used to increase volume which does not seem to meet your goals. A reduction will also lift your tissue after removing the extra; it's all the same operation. The trade off is scars and an inability to breast feed. So you should set up an appointment with a plastic surgeon to discuss your personal goals. Good luck to you; a breast reduction is one of the procedures that patients find most helpful.

Since your goal is to achieve smaller, perkier breasts and to feel comfortable when exercising and wearing fitted clothes, I think a small breast reduction/lift would be your best option for surgery. I would not recommend breast implants, as this would defeat the purpose of achieving smaller breasts. Thanks for sharing your photos and questions. Best wishes.

Although you may wear a DDD bra, your volume is closer to a D. A lift and small reduction should work well for you. If you can be satisfied without implants, you are ahead of the game as there is no maintenance surgery in your future as implant patients must have.