I'm considering removing my 300/325 cc silicone implants. Will they sag and will I need a breast lift? Was 32A, now 32D (Photo)

 I am sorry to hear about the problems you have experienced after breast augmentation surgery.
Although, generally not possible to give good advice without physical examination I think in your case you will be best served with removal of implants WITHOUT mastopexy surgery. This approach will give your tissues the "benefit of the doubt” allowing the breast skin to contract back and avoid additional scarring.  I think, based on the limited information here, that you may be pleasantly surprised how good your breasts will look after breast implant removal (remembering, that it will take several months to see the outcome of the procedure).  Generally speaking what breasts look like after explantation depends on several factors such as: the quality of skin elasticity (the better the elasticity the better the skin will bounce back), the size of the implants used (the larger the implant the more trouble you may have with redundant skin), and the amount of breast tissue present at this time (which may have changed since the time of your breast augmentation). Life experience since your breast augmentation procedure, such as pregnancy or weight gain weight loss, will potentially influence the factors discussed above. If you take these factors into consideration and apply them to your specific circumstances you may get a good idea of what to expect after the implants are removed.Consulting with a well experienced board-certified plastic surgeon in person will be helpful.I hope this, and the attached link (dedicated to breast implant removal surgery concerns) helps. 

The concern of breast sagging after breast implant removal is always there. In some cases it is obvious that a lift is needed, because in some cases a lift is needed even before the implants are removed. In other cases the nipple is well placed, the skin tone is good and there is still some breast tissue to support the skin. Most cases are someplace in between. I would need to see you in person to offer any medical advice, but from your pictures, you have a good chance of nice result without a lift. If after removal there is too much sagging, you can still get a lift. The crease incision is the best one for breast implant removal, and has the most predictable cosmetic outcome in most cases. While individual results will vary, I have included a link below to my website, which includes some before and after pictures. Good luck.