Deborah Pan, MD

Based on your photos it appears that you might not have tuberous breasts but you would benefit from either a breast lift or breast reduction to attain better symmetry and reduce the areola size.

Given that you haven't had children and don't have terrible excess skin or possible muscle separation, liposuction (or even CoolSculpting) would be beneficial.

Unfortunately without photos there's no way to answer your question. You should wait out your results from your initial treatment to decide which way to go next.

Depending on your acceptance of visible scars, it is perfectly acceptable to do an augmentation first and see how the implant alone lifts and fills your breasts. This is dependent on choosing a size that will be adequate to fill the skin envelope. If you prefer a smaller or moderate sized implant, then it may be prudent to consider a mastopexy (short scar or anchor pattern incision) depending on how much lift is required after the implant is placed at the time of surgery.

It will depend on your desired volume size and frame. You can also ask your provider that if you stay within the moderate plus profile, what your maximum volume should be and whether or not that will satisfy your size desires.

Rippling risk depends on many factors including the amount of pre-existing breast tissue, as well as the size of the implant chosen. Silicone implants can be used off-label by any plastic surgeon before the age of 22, and you just need to have a thorough discussion with your plastic surgeon. Otherwise, you can always wait the 9 months for an implant with a slightly lower risk of visible rippling.

Unfortunately an abdominoplasty is not covered typically by insurance. If you have recurrent fungal infections those should be treated with appropriate topical medications and good skin care to prevent moisture trapping. Surgical solutions are considered cosmetic.

Abdominoplasty after c-sections are commonly done and there is very little downside consequence. But as always, a full physical exam is important by a board certified plastic surgeon.

Ideally we all want to do surgery once, so if weight loss is on your life plan, a breast lift should be done when that is achieved.  But if you're motivated to go forward with surgery now, you just have to be aware that some deflation and sagging can occur after surgery if you do lose additional weight. Also bear in mind that the surrounding chest/abdomen also dictates the proportionality of the final breast and if that changes, your final results may not fit your frame.

Depending on the issue at hand, as determined with a physical exam, you can do skin tightening with Ultherapy. Or, if fat is an issue, then Kybella or CoolMini can be offered to help reduce upper neck fat, depending on whether your upper neck fits the CoolMini applicator.