Upper breast fullness and cleavage
A breast lift alone will give you a decent size but will not give you a good upper breast "fill" and cleavage. For this you need implants. Principally you need to be seen, examined, measured and then the options discussed with you.
Good luck, you will look terrific!
Add volume with implants for deflated breasts
Theoretically, a breast lift alone should not reduce the size of the breasts since none of the breast is removed. However, the problem long-term is maintaining a nice shape with some fullness in the upper portion of the breast. None of the techniques currently used deliver that with a lift alone, so most often an implant helps with shape in the situation of weight loss or changes after breastfeeding. You will have to accept that there will be some size increase, so to keep this minimal a low-profile implant will probably be the best choice.
A breast lift alone typically decreases breast size
It is common for a larger-breasted to lose volume and have increased laxity or sagginess after childbirth. The best advice can be given to you after meeting with you in consultation and examining you. Only then can the list of recommendations be made. In general though, if you want to preserve your fuller breast size, you would most likely best benefit from a breast lift accompanied by an approporiately sized implant. After examining you and taking measurements, the size options of breast implants can be determined and then you can try them on in a sports bra to get a basic idea of what to expect.
I hope this helps.
Options for sagging breasts
IT sounds as if you may benefit from a breast lift withpartial volume reduction and replacement with a breast implant to restore volume and upper breast fullness.
Breast Implant size and Mastopexy
A mastopexy will tend to make the breasts appear slightly smaller as the tighter skin will compress the gland. It is hard to tell for sure which implant will be best for you, but 390 will be close.
Breast implants with breast lift only if you want to be bigger.
A good internal breast lift alone will leave you a D cup. No tissue is removed. You could have small implants at the same time if yould like to be a little bigger. I predict a good result either way.
The answer is yes, your breast will likely be smaller after a lift. Remember a significant part of the reason you're in a D cup is the extra skin you need to support. Removing that skin will put your breast tissue into a nicer package but likely a smaller package (perhaps a C cup depending on how much ptosis or droop you have).
Which leaves you thinking about implants to get you back that D cup size. Couple problems:
1. Your skin has drooped partially because of lost elasticity. Loading that skin with an implant may, in the future, cause you to droop again.
2. It may be tough to find an implant that fits your breast width without making you too big. Remember there isn't an implant that looks like a pancake so an implant may put you into a DD that isn't appealing to you. Your surgeon can guide you through this decision making process.
It is very important to communicate your size goals with your surgeon. In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “natural” or “C cup” or "fake looking" means different things to different people and therefore prove unhelpful.
Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup size may also be inaccurate.
I use intraoperative sizers and place the patient in the upright position to evaluate breast size. Use of these sizers also allow me to select the press implant profile (low, moderate, moderate plus, high-profile) that would most likely achieve the patient's goals. The patient's goal pictures are hanging on the wall, and allow for direct comparison.
I have found that this system is very helpful in improving the chances of achieving the patient's goals as consistently as possible.
By the way, the most common regret after this operation, is “I wish I was bigger”.
I hope this helps.
The larger the implants, the potential for more problems with wound healing and long term issues like relapse sagging. You can do a baggy test or try sizers on to see how the volume fits in a bra for you.
Breast lift without implants
If you are a "D" already, and as petite as you say, my guess is that a breast lift alone may suffice.
You need to be seen by a surgeon to examine you for a better idea and to discuss your goals.