I'm a 38 D if I get a breast lift would I need implants to keep my same breast size? (photos)

This is best evaluated in person, however, usually, one loses about 1/2 cup size with a lift.  Thus, you may prefer to have an implant placed.

My inclination after reviewing your photographs is to say you probably would not need implants in conjunction with an uplift. They may prove to be helpful in the future if your breasts become more empty or droopy but at this stage it appears you have enough volume to not require them.  A face-to-face examination will give you the most precise answer and best advice.  It appears that you had one or more pregnancies however the patient in the goal photograph has probably never been pregnant and has moderate sized implants in place.  I would not set this as a realistic goal but do think that you are a candidate for an uplift and should get significant improvement and satisfaction.  Please review the video link attached for a discussion of uplift surgery options. Best wishes,Jon A Perlman M.D., FACSDiplomate, American Board of Plastic SurgeryMember, American Society for Aesthetic Plastic Surgery (ASAPS)ABC-TV Extreme Makeover SurgeonBeverly Hills, CaliforniaIG: jonperlmanmd