You will definitely need a FULL mastopexy with an anchor scar to remove all of the excess skin and reposition the nipple areolar complex.
Hello dear, thanks for your question and provided pictures with information. I recommend you a breast lift with LJ incision + soft cohesive silicone implants
The Horndeski Method™
You are an excellent candidate for a new technique
called The Horndeski Method™.The breast
tissue is reshaped creating upper pole fullness without implants, elevated
higher on the chest wall and more medial to increase your cleavage.Aligning the areola and breast tissue over
the bony prominence of the chest wall maximizes anterior projection.This technique avoids the ugly vertical scars
of the traditional technique, maintains nipple sensation and the ability to
Gary Horndeski, M.D.
Your only realistic option is a full breast lift. The position of your breasts is much too low for any other procedure. You can do this procedure with or without an implant. You are correct in that the main trade-off is the potential for poor scars. Noone can predict how you will scare so you must decide whether or not you could still be happy if you liked the shape, size and position but had poor scars. If not, it is not worth the risk because we cannot "take the scars back".
It looks like you need more than a crescent lift. You might be able to have a vertical lift with implants. Best of luck.
Breast lift and augmentation at the same time is possible
The purpose of a crescent lift is to move the position of the nipple a little higher. The position of your nipple and your degree of breast droopiness is too great for a crescent lift. You can get a lift and augmentation at the same time. I would recommend that you ask your surgeon if he or she performs the I.D.E.A.L. Breast Lift, which is better approach for moderate to severe droopiness.
I understand your concern about scarring, but in my experience, my African American patients seem to do well. You could look at the link below to see before and after breast augmentation lift photos of several of my patients similar to you.
Crescent and Augmentation
Thank you for including the pictures. I appreciate your concern about scarring but with the extent of sagging that you have, a full mastopexy (Anchor lift) would be required to correct the problem. Any of the less extensive lifts will unfortunately not correct the significant degree of sagging that you have.
I would suggest that you visit your Plastic Surgeon and discuss your concerns and establish a treatment plan that has a realistic chance of getting the desired result.
John J Obi,MD
Breast lift with implants, some advices:
Thanks for sharing your concerns with us.
After having analyzed all the information and photos provided to us, I realize that you have asymmetrical and sagging breasts.
In this regard, i recommend a breast lifting with implants to get a bigger breast with adecuate projection. In other words, you need breast volume (implants) and you need breast projection (the lift).
I recommend you, to use a microtexturized highly cohesive silicon implants ("gummy bear" implants), with high projection and different volumes of each side (bigger in the left breast) to correct the breasts asymmetry you have.
Given the shape and position of your breast, you are going to require more than a crescent lift in order to be happy. This will definitely leave you with more scars than you might desire. Absolutely your lift and augmentation could be done at the same surgery. Best of luck.
Breast lift with limited incisions
You have drooping of the breasts known as ptosis of the breasts. Understandably, you desire a naturally fuller and lifted look of the breasts and would like to achieve this with the least amount of incisions/scars possible. There are varying degrees of ptosis which require different degrees of surgical correction. You have Grade 3 ptosis which is moderate to severe breast ptosis with the nipple positions below the creases under the breasts known as the inframammary creases. This severity of ptosis requires more than a limited lift such as a crescent mastopexy. A "full lift" is when the nipple and areola are repositioned higher on the breast mound with reshaping of the breasts with removal of skin. This often requires the traditional "anchor" incision. However, with the addition of more volume to the breasts by using breast implants, you may be a candidate for the newer type of lift known as a "lollipop" lift. This type of lift elimates the incision and scar under the breasts in the inframammary creases, but still allowing the creation of ideal breast shape and projection.
You will benefit by consulting with a board certified Plastic and Reconstructive surgeon that routinely performs these types of surgery.
Good luck with your surgery!