Breast reduction 15 years ago. Went from 38DDD to a 38C. Will I require a lift if I opt to have a breast augmentation? (photo)

Very interesting question and a more reoccurring story.  Patient has a breast reduction and then goes through the life's processes - pregnancy, weight gain, weight loss, gravity.  You have different breast shape and size then you started off with.
You need to see a board certified plastic surgeon with experience in these patients.  He will help you decide what your end goal is - size and shape - and then decide the best way to get there.  I depends on the quality of your skin and tissue.  Autoaugmentation, Implants, A lift with implants etc all are options.

Hello. Based on your photos you will certainly need a lift either prior to or during your augmentation procedure. It appears that your nipple is completely below the inframammary fold because of this a lift is required. Staging the procedure is sometimes warranted if there is too much skin excess, but that does not appear to be the case here. Best of luck. 

Hello and thank you for your question.  The
best advice you can receive is from an in-person consultation.  With that
being said, based on your photographs, the best shape and contour could be
achieved with a small implant and a breast lift.  A breast lift with a small implant can result in a very
nice shape if good technique is used.  The size, profile, and shape of
the implant is based on your desired breast size/shape, your chest wall
measurements, and soft tissue quality.  This decision should
be based on a detailed discussion with equal input from both you
and your surgeon.   Make sure you specifically look
at before and after pictures of real patients who have had this surgery
performed by your surgeon and evaluate their results.   The most
important aspect is to find a surgeon you are comfortable with. I recommend
that you seek consultation with a qualified board-certified plastic surgeon who
can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Doing a augmentation and mastopexy simultaneously after a previous breast reduction is risky. You stand a very high chance of losing blood supply to the areola.A safer option is to first perform a breast lift. Let this heal and then perform an augmentation at another operation several months later. Staging this surgery decreases the stress on the blood supply. A simultaneous augmentation with breast lift is safe in most people, but you are in a different situation do to your previous surgery.
Best Regards,Prashant Soni M.D.

Hi! I do not recommend doing a secondary lift as that can compromise blood supply due to scarring and also there runs the risk of  tissue necrosis. Doing a fat transfer to the breast will help re-inflate the breast and cause a natural lift to the breast. A silicone implant will not help lift the breast, the implant would be sitting in the upper pole of the breast and give more fullness there with your natural breast tissue lying over it, not causing any lift because the implant is under the muscle. I think the best option for you would be a fat transfer. Hope this helps!

You have plenty of breast tissue but have suffered significant ptosis.  It may be best to do a lift to recreate the breast shape you had right after the reduction.  Implants may worsen ptosis in the long run. 

Yes, you will need a mastopexy here to reposition the npple and redrape the skin properly over an implant if you choose an implant.

Judging from your photographs, it appears that you need another reduction mammoplasty to tighten your breasts and to remove some of the excess breast tissue in the lower part of your breasts. This would give you an uplift. It also appears that you would need no incisions around the areola, so the procedure would be less involved than your original reduction mammoplasty.
If you want more volume in the upper pole of your breasts, breast implants or fat transfer would achieve that goal. Of course, a liposuction is necessary to procure the fat for a fat transfer (grafts). I don't believe implants alone would result in an attractive appearance.
Thank you for your question and photographs, and best of luck to you.

Thank you for some good questions.  The breast augmentation you desire can provide just 3 things: increase in size, better fullness above and some help with asymmetry of size.  Clearly after all these years your left breast sags more.  If you want any correction to that a breast lift would have to be done, at least to the left side.  That breast lift should likely give no more new scars but replace the scars that are there.  It is an opportunity to have less skin on skin, better fullness and less heaviness below.
I think if you keep in mind what the implants themselves can do and what a breast lift by itself can do, then you can make your best decision about which one, or both, you can do.  Hopefully this is helpful.

hello, thanks for your question and provided information. I recommend you to get a breast reduction revision with lift, you can also have augmentation with lift. You can achieve very nice results.