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

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!!