I am a 44H bra size, I am 52 yrs old my weight is 260, I have lost 10 pounds. (Photo)

Thank you for the question and congratulations on your weight loss thus far and your decision to proceed with breast reduction surgery; this operation tends to be one of the most patient pleasing operations we perform. 
 
Before undergoing the breast reduction procedure it will be very important to communicate your size goals with your surgeon (who you should choose very carefully). Most patients wish to achieve enough of a reduction to help with their symptoms while remaining proportionate with the remainder of their torso.  Show your plastic surgeon, utilizing visual aids such as goal photographs what you would like to achieve.  Otherwise the use of terminology alone can be a source of miscommunication.
With the goal of improving communication with my patients I find the use of photographs of “goal” pictures (and breasts that are too big or too small) very helpful.  For example, I have found that the use of words such as “natural” or “C or D cup” 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. 
Once you have communicated your goals carefully, your plastic surgeon will be able to provide you thoughts regarding whether your goals are realistic/achievable or whether additional surgery may be necessary to achieve them.
Best wishes with your breast reduction procedure; hopefully you will be very pleased with the outcome of the procedure performed.

Neither the uploaded photo nor the information provided is adequate for me to provide an accurate answer on line.  Recommend that you schedule an in-office consultation with a board certified plastic surgeon who performs hundreds of breast procedures annually with favorable patient reviews, and numerous before and after photos on his/her website. If you are seeking medical insurance coverage for the BR, weight reduction may be necessary.Kenneth Hughes, MD, Board Certified Plastic SurgeonLos Angeles, CA

Thank you for your question and photo,              
The Bellesoma Method is a current technique to lift and/or reduce breasts without using implants or the ugly vertical scars.  The incisions are hidden around the areola and in the inframammary crease. The vertical incision has been completely eliminated. The areola incision heals almost invisibly due to the fact that there is hardly any tension on the closure. With this particular technique, ducts are preserved along with nerve supply maintaining nipple sensation and the ability to breast feed. Because the breast is reshaped internally and is secured to your chest muscles, upper pole fullness is possible without an implant. Attached is a patient who underwent The Bellesoma Method. Please note that her tissue was used to create upper pole fullness and cleavage without any foreign materials (mesh, implants, etc).  It is a proprietary technique that only surgeons that have been trained by me can perform. I hope this helps. 
Best wishes and kind regards, 
Dr. Gary Horndeski