Tacoma Breast Lift doctors

You have very good reason to be concerned, but not necessarily because you are African American. While its true that some people of color tend to make thicker or keloid like scars, this is actually quite unusual on the breast unless there is some problem with wound healing. I do lifts and reductions on African Americans all the time and they get very satisfactory results.

It is a misconception to think that a Binelli Lift always results in a lesser scar. As Dr. Rand pointed out, the very worst scars from Binelli Lifts are a result of trying to avoid the scars of a more complete lift is needed (which can turn out quite good), and trying to accomplish too much with a Binelli lift which results in excessive tension on the wound leading to widening, pigmentation irregularities, and generally poor scarring. With a very large areola you are at even more risk for problems. Adding an implant tends to put even more tension on the scar. Also Binellin lifts tend to flatten the breast, so if your breast is already flat, the Binelli lift would not be a good choice.

Although you might prefer to avoid the scars of a lollipop or traditional lift, those might ultimately be a better choice for your situation.

Women of African heritage in the United States often have a lot of racial mix. No rule holds across the board. Paler skin types tend to make less noticeable scars than darker skin types.  My African American patients usually make good scars if they have no personal or family history of hyperpigmentation (scar darkening) or keloid formation (overgrowth of scars). Less scarring can be beneficial for the person at risk for unsatisfactory scars.  The choice of implant size and pattern of breast lift incisions is a judgement call that can only be made in person.  The implant and skin envelope need to match.  Too tight a skin envelope can create tension that results in bad scars for any skin type. Too large a skin envelope leaves droopy skin.  Implants and lifts done together have a high revision rate, approximately 20%, because it is difficult to get it exactly right even by the most experienced plastic surgeons.

From your photos, I think a vertical lift would get you close to the look that you like.  I do not think an augmentation with a periareolar lift would.  First of all, your volume is similar to the model's.  She does not have alot of upper pole fullness that an augmented breast would have. 

I think the aug and periareolar lift results in a particular look that does not look natural, at least in patients with your degree of sagging.

I must compliment you good taste.  You wouldn't believe the photos some patients think look good and natural!