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

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

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.