Can the breast lift be tailored to what you want? (photo)

While you can to a degree tailor the lift to your desired results, the surgeon cannot accomplish any shape without choosing the right technique.     I your situation, a Binelli  (or circumareolar) lift would make things worse.   The areola would stretch and the buttom of you breast would be too full and sag more.     At a minimum, you would need a vertical scar with removal of some breast tissue in the lower breast.         I would suggest you don't need an implant at all, just reshaping of the breast, but you have to be accepting of the scars.  

Hello:
I see that you are concerned about scaring with a breast lift augmentation. Your photos reveal a good loss of upper pole volume and widening of the breasts that are lying low on the chest wall. Your idea of doing a Benelli lift with a scar only around the nipple followed by a breast augmentation will result in flattening of your areola, poor final shape and wide undesirable scars. It is not possible to contour the shape of the breast well with a peri areolar incision. 
My recommendation would be to do a vertical "lollipop" mastopexy augmentation to reduce the width of your breasts and support the implant and your breast tissue into a higher position on your chest. The tension will be spread along the longer scar and you will avoid the flattening effect of the peri areolar lift.  You have a good amount of breast tissue so you would have the choice of a saline or gel implant to give the best result. I think your overall shape will be better in the long run with this approach.

You need a formal evaluation by a licensed plastic surgeon and expert in breast lifts, revisions and augmentations to determine what is best for you and your goals.
Breast lift surgery can improve a woman's breast shape by repositioning the breast mound at a higher position on the chest and then centering the nipple and areola on the breast itself. If there is enough breast tissue, I can perform a highly aesthetic mastopexy without the addition of further volume by internally rearranging the breast tissue and removing excess skin. If more volume is needed, especially in the upper portion of the breasts, we will discuss the possibility of fat grafting or silicone gel implant placement. The type of incision required for this surgery (circumareolar, “lollipop” or “anchor”) and the lifespan of the lift depends on each patient’s condition, breast tissue, genetics, weight and hormonal fluctuations, and desired results.
Augmentation with mastopexy is a challenging surgery that requires significant experience to create a shape that is youthful, natural, and proportionate to the body, while managing the native tissue as well as fat grafts or implants. When performed properly, it can result in a dramatic improvement to a woman’s breast appearance.
I suggest consulting with a board-certified plastic surgeon and expert in Breast Lifts. - Dr. Cohen

Great question!  As plastic surgeons, our goal is reduce the amount of scarring necessary to achieve the goals you desire.  Unfortunately with a Benelli lift, all it does is move the nipple and areola up a 1-2 centimeter, there really isn't much breast skin that is removed.  It also really isn't a lift as the breast still stays in the same position.  Only with a vertical or horizontal lift can the breast tissue itself be lifted higher onto your chest as well as really having excess skin removed.  Looking at your photos, you will need a full lift - either vertical or traditional which both has its advantages and disadvantages.  Best of luck and hope this information helps!
- Dr. Roger Tsai  
Board Certified Plastic Surgeon

The inverted-T anchor scar should be obsolete because of the very long horizontal scar and other design problems, such as an overelevated nipple. The Benelli is unsatisfactory because it provides no lift and just distorts the areola, sometimes making the breast look like a tomato (this method has fallen into disfavor). The vertical method is best.

Your breasts are large and low on the chest wall.  The technique I recommend is The Bellesoma Method.  This will reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage.  The weight of the breast is transferred to the underlying pectoralis major muscle resulting in pain relief and long term stability.  Vertical scars are avoided, nipple sensation and the ability to breast feed are maintained.  Best Wishes,Gary Horndeski, M.D.

From your photographs, it seems that a doughnut mastopexy would probably not give you results that live up to your expectations. Also, this type of breast lift simply does not have a lot of longevity. It usually stretches and wouldn't give you a nice, lifted appearance

Hello and thank you for your question.  The best advice you can receive is from an in-person consultation.  With that being said, based on your photographs, the best shape and contour could be achieved with a vertical or wise pattern breast lift.  I rarely recommend a Bennelli or circumareaolar (donut) lift.  Over time, the areola tends to enlarge with a thickened scar.  The other even worse problem with a circumareaolar lift is that it flattens out the shape of the anterior breast over time.  A vertical or wise pattern lift with an implant can result in a very nice shape if good technique is used. This decision should be based on a detailed discussion with equal input from both you and your surgeon.   Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and evaluate their results.   Best wishes and good luck. Richard G. Reish, M.D.  FACS Harvard-trained plastic surgeon

It is difficult to determine the answer from the pictures posted- with arms raised. I recommend an in person evaluation by a plastic surgeon to be measured and discuss your goals. After I measure and discuss goals with my patients, we then look at pictures of women with similar measurements. My patients tell me that this process is very helpful in determining what size breast implant and type of surgery is right for them. 
Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author             RealSelf Distinguished Hall of Fame Inductee

Dear thesweetestchick,
My preferred lift is a lollipop lift when a periareolar won't do (ie greater than 2cm lift required). The lollipop technique was created by a Canadian plastic surgeon named Elizabeth Hall-Findley and treats the breast as a three dimensional structure instead of two dimensions (anchor - lift). Most importantly it does not require the horizontal component scars that the anchor-lift requires and breasts appear much more natural, lifted, and less boxy. Lastly, the lift lasts longer because the lollipop doesn't rely on the skin to hold the breast up, its actually breast tissue that's being brought together to support the breast and hence improves longevity. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD

Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery