How small should I go from 38L, and what method would be used? (photos)

You are an excellent candidate for a new technique
called The Ultimate Breast ReductionTM. This technique avoids the ugly vertical scars
of the traditional technique, maintains nipple sensation and the ability to
breast feed. The breasts are reshaped
creating upper pole fullness, elevated higher on the chest wall and more medial
to increase your cleavage. At size 38
each 200 grams of tissue corresponds to 1 cup size change. Neck, back and shoulder pain is relieved by
transferring the weight of the breast to the underlying muscle. This allows the patient to keep the size
breasts proportionate to their body without undergoing excessive
reduction.Best Wishes,Gary Horndeski, M.D.

The requirements you write are very hard to guarantee in reduction surgery. Plus the increased risk if doing the bi pedicle or uni pedicle techniques on a very long N/A distance from the mid clavicular line cause one the think of other older alternative operations. Like the free N/A graft reduction... 

Surgeons vary in what specific technique they prefer for a breast reduction and a good surgeon can get a good result with any of the techniques. But no surgeon, no matter how good, can tell you exactly what cup size you will be, nor can they guarantee the sensation will stay intact.