Although you didn't specify whether you had a breast lift together with breast augmentation, the fact that you paid $10, 000 for your surgery suggests that you did. If that is the case, it is not that unusual to see some irregularity in the shape of the nipple in the early stages, that is the first 6 months or so, following such procedures. Your surgeon most likely did what most of us do when doing breast lifts, and used an actual template to design a perfectly round areolar border. Even when we do this, there are forces that act on the tissues after surgery over which we have no control, such as gravity and the contraction of scar tissues. These things may take what started as a perfectly round areola and distort the shape. This doesn't mean that your surgeon did anything wrong or didn't "make" your areola round; it just didn't stay that way. Having said that, it is still early, and things may still change as scar tissue and breast tissues relax and tensions even themselves out. In the end, if your areola is still irregular over the next 2 or 3 months, it is usually not that complicated to simply revise the shape under local anesthesia in the office procedure room. As far as costs of such a procedure go, each surgeon has his or her own policy on that, so I can tell you what I and most of my colleagues that I know around here do. We typically do these minor revisions up to one year after surgery for only the cost of any operating room facility charges, equipment and supplies, and anesthesia services that may be needed. Most of us don't charge a surgeon's fee for these kinds of things. For something like what we are talking about here, I would likely do the procedure under local anesthesia (therefore no anesthesiologist fee) in our minor procedure room (therefore no operating room fee) for minimal equipment (suture and things like that), so the cost would be very minimal. In the end, everybody has to realize that these are elective procedures that the patients as well as surgeons decide to do, and there can be no guarantees on the part of the surgeon about outcomes because so many things are beyond our control. Thus, the most appropriate way to handle situations like this when the surgeon did everything in his power to achieve a good result and practiced at, or above, the community standard of care and the result was still not satisfactory, is for everyone involved to share their part of the responsibility to get the best outcome. Thus, if the surgeon needs to do a minor revision for no surgeon fee, he should, but the patient should cover the actual costs of doing that too, so that the surgeon does not have to lose money on things that were beyond his control and to which the patient consented and agreed to (or should have if proper preoperative consent were performed).