Did my pre-op measurements justify an anchor lift, or would implants alone have been appropriate? Can this be repaired? (Photos)

I am sorry for your problems, but your case is a prime example of why I never recommend mastopexy (lift) at the time of the augmentation. A two stage procedure is the best option and very often a mastopexy is not needed.
You have the two problems most associated with a combined procedure: nipples too high and unnecessary scarring.

I think you needed a lift and either a lollipop or anchor would have been indicated. I think your result is quite nice and I’m not sure specifically what you don’t like about it. Naturally the nipples look high when you hold your arms up but with you seems at the side it looks good. I would not advise a revision.

What was your presenting complaint at your initial consultation? Did you ask for a breast lift, did you ask for augmentation, or did you want both lift and augmentation? It’s difficult to judge a treatment retrospectively without an understanding of the entire situation at that time.

We can’t tell from the picture if your nipple is below the IMF.
Typically the left breast sits higher on the chest wall than the right side.
And your preoperative picture the left nipple sits slightly lower than the right side, so the left breast probably needed a lift.
The amount of raising of your nipple position was not very much so a full anchor scar was probably not indicated.
Each plastic surgeon will have their own way of doing these procedures.
Some plastic surgeons are better than others.
Finding the right plastic surgeon is not at all easy or straightforward.
To find the right provider, I generally recommend patient start the process by having multiple in person consultations with several plastic surgeons in your community.
Bring pictures of yourself to use as reference during the consultation.
During each consultation, ask each provider to open up their portfolio and show you their entire collection of before and after pictures of previous patients who had similar body characteristics to your own.
An experienced provider should have more before, and after pictures than you have time to look at during the consultation.
By seeing lots and lots of outcomes of previous patients who had similar body characteristics, you’ll start to get an understanding of what average results look like on patients with your candidacy for the procedure in the hands of each provider.
At this point, it’s going to be difficult to improve your outcome.
Your nipple position is high and lowering the nipples is not really possible.
There’s usually always room for some improvement, but restoring the outcome to a high-quality result may not be possible.
At this point, you need to find a really talented plastic surgeon for breast surgery.
Finding the right plastic surgeon to work with is often the most important variable and is more difficult than most people realize.
Average plastic surgeons do average work.
Consistent, exceptional work is usually done by exceptional plastic surgeons.
Best,
Mats Hagstrom MD