Can I still remain a 40D with a D implant to achieve a perky look, or do I need to be a 40DD? (photo)

Any breast implant that you chose will add volume and frankly will  "make you bigger".  So in a nutshell, if you simply add an implant of any modest size, you will be bigger.  I think what it sounds like you want is an improved shape, uplift to the breast, and upper pole fullness.  That would be best achieved in my opinion, utilizing a breast lift in conjunction with a modest silicone gel implant placed under the muscle.  I hope this helps.  Make sure to seek the advice and expertise of a board certified plastic surgeon.

Your photos are helpful. Although a full physical exam is
needed to get the best answer, I would suggest getting a breast lift to achieve
the look you want. Any implant will increase the size of your breasts, but
won't necessarily give you the desired results. If you're satisfied with the
size, a breast lift performed by an experienced, board-certified plastic
surgeon can give you perkier, more youthful looking breasts. Good luck!

Since
you are a 40 D and want to stay the same size, you do not need implants. You are an excellent candidate for a new
technique called The Ultimate Breast LiftTM. This technique reshapes your breast tissue
creating upper pole fullness, elevates them higher on the chest wall and more
medial to increase your cleavage. This
technique avoids the ugly vertical scars of the traditional technique,
maintains nipple sensation and the ability to breast feed. Best Wishes,Gary Horndeski, M.D.

From the pictures it looks like you are a full D cup now, adding an implant will make your breasts larger.  As to the bra size it depends on the implant size.  It also looks like you might benefit from a breast lift.  I would meet with a few PS in your area to learn about possible options.  Good luck!

Based on the photographs you provided you benefit most from a breast lift.You have plenty of breast volume it's just in the wrong place,a lift would remedy that problem.Thanks for the great question. 

I would offer three options : 1)do nothing 2) breast lift or 3) breast
lift with implants. Breast implants without a vertical or anchor
breast lift would make your breasts appear worse, with the implant high
and the breast tissue falling off the implant.Kenneth Hughes, MDLos Angeles, CA

I would strongly advise not talking about C cup size when communicating your goals.  First, remember, that a D cup in one bra designer could be a C cup in another designer. Cup sizes are not standardized.  You stated you want more upper pole fullness and volume.  If you are seeking more volume in your upper pole, an implant will be needed and this will make you fuller in size (and cup size).   You also appear to have some sagging that will need to be address with some form of breast lift.  To learn more about your options, please visit with a board certified PS.  Best wishes,Dr. BasuHouston, TX

The natural sag of the breast can make it difficult just to improve the upper portion of the breast without more breast reshaping.Please find an experienced Board Certified Plastic Surgeon and member of the Aesthetic Society using the Smart Beauty Guide. These Plastic Surgeons can guide you on all aspects of facial surgery, breast augmentation and body procedures including tummy tucks or mommy makeovers!