Catherine T. Milbourn, MD, FACS (retired)

Congratulations on your weight loss!  One of the changes we see with weight loss is the loss of facial  volume which you are seeing now in the cheek and under eye region.  You may well be able to manage this volume change with a filler, understanding that many fillers last only 1-2 years, or with fat grafting.  You will need to be seen in person to assess the changes and to have a good discussion of the different options for treatment.

The incision is probably not the main reason for changes in sensation of the breast skin or nipple after breast augmentation, though peri-areola incisions have a higher chance of being associated with sensation changes than inframammary incisions. Changes are more related to the size of the implant and the amount of dissection needed to open the space for the implant.  In many cases there are temporary changes in sensation due to the stretching of the skin and post-operative edema which gradually improve with time and healing.  I hope you have a wonderful result from your surgery.

These are good questions that should all be considered when you finally have a consultation with a plastic surgeon.  In general, no breast tissue is removed when a lift is performed, simply the removal of a section of the skin so that the breast is not sagging as much, so the actual volume of the breast is the same.  However, the distribution of the breast tissue is changed, with the tissue somewhat compressed against the chest, so it may appear at first to be slightly smaller.  With a lift there is always a little settling of the tissues over the months after surgery, especially if the breasts are large, with less compression of the tissue, but usually not as much sagging as preoperataively.  The scar pattern for a lift would be decided depending on the current shape and size of the breasts and some scars may widen with time or fade well.  In general, during the healing time of 4-6 weeks you will need to wear a bra for support and avoid strenuous activities that might disrupt the healing. 

It is good that you recognize the asymmetry between the breasts before surgery so that you can discuss the various options for addressing it.  There are several ways to deal with asymmetry including ignoring the difference and just augmenting the breasts, knowing that the addition of an implant will partially camouflage the difference, using slightly different sized implants to adjust for the volume difference, doing a small lift on the lower side with the more ptotic tissue and lower nipple or even removing a moderate amount of breast tissue to reduce the larger breast to the same volume as the smaller one, then using more symmetrical augmentations.  You will need to discuss all these options with your surgeon, as there are advantages and disadvantages of both.  

In general a tuck will take about 2-3 hours, but the length of time needed for a procedure depends on the amount of tissue that needs to be removed and if there are ancillary procedures to be performed, so it is not really possible to fully answer your question.  Recovery is a process and cannot be timed to the exact date.  Again, depending on the amount of tissue to be removed and the amount of muscle tightening needed, time to driving may take 2-3 weeks and also depends on the degree of discomfort and need for pain medication, as one should not drive while taking pain medication.