3 months post purse string mastopexy, am I stuck with all of this puckering? (photos)

Thank you for your photo and question. At three months postop, there is still significant time for continued healing and improvement. I would wait at least another six months for scar softening and maturation before considering any revisions. I do think you will continue to improve over the next few months. Certainly, your surgeon is the best person to address your concerns. Best regards.

purse string around the areola can leave this rippling for a very long extended period of time. not sure about the dent, only the surgeon would know why it is there.

You are unfortunately another victim of the fraudulent periareolar lift, round-block lift, donut lift, purse lift, Benelli lift or Goes lift among other given names. It is not a lift, no it is not AT ALL, the nipples never move towards no one direction, they stay the same location and never ever any lift is achieved. It is easy understandable that cutting away skin around the areola does not apply any momentum or transposition effect on the areolas, they do not "move".Not only that, the breast reshaping is not accomplished, since just by pulling skin all over the breast towards the areola does not provide a breast gland re-structuring (a must-do in all breast lifts); to the contrary, a deforming and grotesque effect of massive flattening is obtained, as it is obvious in your case.Last but not least, the massive shortfall of skin around the areola creates a massive perimeter and circumferencial tension and puckering, as an obvius consequence of stitching together one external ring which may be 3-4 times the length of the inner areolar-edge ring. This massive tension creates the rippling or puckering lines irradiating from the areola, and sooner or later develops hypertrophic scars and scar widening. That is why among surgeons we know this "technique" leads to breasts like a "fried egg" (flattened with massive central "yolk" areola and rippling around) or Japan flag-like.It is absurd and reckless intending to suspend, sustain and reshapen a whole ptotic breast which is out of shape just by means of a magical periareolar skin resection. Needless to say this technique has been abandoned worlwide many decades ago by surgeons who practice in fields or realistic seriousness, honesty and results-oriented philosophy. Your current sequels and shape will not improve much, actually they may well worsen overtime. You are bound to a full revision, with a professional with solid experience in brest revisions of failed periareolar lifts.Let me insist: your disastrous result is not due to poor planning or poor execution, yours is the typical, usual, regular and normal outcome of any periaerolar lift; do research on RS or direcly from my Q&A in my profle and you'll find hundreds of women same victim of such procedure.About the revision and repair of this mess it is not easy or accessible to any surgeon, needs deep understanding and knowledge, since it consists in coverting the mess of periareolar missing skin into an inverted T (Wise pattern) breast lift on a cut-as-you-go intraoperative improvisation basis. This means the surgen can`t make many predictive preoperative markings, and the final breast tailoring has to be made during the procedure on demand of the real skin shorfall and glandular reshaping requirements. Nevertheless I'll have you know the procedure is quite standar in expert hands and I have performed many like you; actually withing a couple of weeks I will operate on a very similar case to yours. If you wish better grounded opinion please do post or send privately well lit, focused and standard images: frontal, both lateral and both oblique views.
Feel free to request any additional information from me.