There are three important elements that need to be addressed here - Shape, size and herniated nipple areolar complex.
As for shape, release of constriction, particularly at the bases will help control shape and symmetry. As for size, while fat graft is a viable option, it is somewhat unpredictable and based on your height and weight, and appropriate size implant may afford both improved shape and symmetry. Thirdly, a periareolar mastopexy will address the puffiness. Thank you.
Breast augmentation may exaggerate any natural asymmetries or nipple malpoaition one may have. Chosing a smaller implant may be the key in avoiding over-exaggeration of these issues. Without adequate soft tissue coverage, implant palpability, capsular contracture, rippling etc happen more frequently. Please consult board certified plastic surgeons for appropriate guidance. Best.
As long as the affected area feels soft, it may just be bruising. It is important however, that you should communicate with your surgeon and be examined. Best.
Postioeratively, your nose will continue to undergo changes for several months. In fact, final result may take 12-18 months to show. Please be patient, keep your follow up appointments with your surgeon. Best of luck.