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

Thank you for the question.   Some general thoughts but be helpful to:
 Different patients will present with different degrees of "sagging" (breast ptosis).  The type of breast lift indicated will mainly depend on the patient's physical examination and goals. In some cases where the nipple/areola complexes are in a "borderline" position when it comes to requiring breast lifting, breast augmentation alone may create the "illusion" of a breast lift.  Very minor "sagging" may be corrected using a circumferential areolar incision (Benelli breast lift) ; more severe breast ptosis may require a vertical or "anchor" breast lift pattern.   In your case, a Benelli breast lift will not suffice when it comes to achieving a powerful enough breast lift. A vertical or "anchor" breast lift will be necessary.  I would caution you about utilizing breast implants in the sub glandular position; you will learn a lot about the pros/cons associated with sub muscular versus sub glandular breast augmentation surgery on the Real self website.
Again generally speaking, breast lifting involves some degree of tightening and lifting of the breast skin envelope.  In order to tighten the skin envelope, skin excision is necessary;  this results in the presence of scars.  Sometimes, the presence of scars is a “dealbreaker”;  patients would prefer to leave their breasts unchanged than to have scars. At other times, patients  prefer to have the improvement in breast position, shape, and (possibly) size  and are willing to accept the trade-off of the scars.My best advice:  if you choose to proceed with breast surgery, select your plastic surgeon carefully. Make sure that he/she has significant experience achieving the types of outcomes you will be pleased with. Then, communicate your goals carefully, as  well.   I find that the use of goal photographs and computer imaging are very helpful during this communication phase. Working together you will come up with a good plan to achieve your goals.   
I hope this helps.

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