Long Awaited 450 Silicone Implant Removal, Breast Lift and Fat Transfer

I ended up going in to get my last follow-up, as it had originally been canceled due to Covid concerns, so I was able to bring up my concerns.
Unfortunately, without getting a complete new lift, he cannot help me. As the cost of a complete lift would be very close to my original procedure, I have decided against it. I was hoping that as a returning patient I would get "some" loyalty pricing adjustment, but even though I expressed that sentiment, it was not to be. Maybe I will change my mind at a later date, or get other opinions. I am disappointed, but I can't see spending a total of 14K on two breast lifts within a year. It's not that I can't come up with the funds, it's the principle that always gets me. Grrrr, don't start me on a rant, LOL.
My main issue is that I wanted the 45-55 breast ratio and ended up with more of a 50-50 ratio, with less lower pole fullness. In order to fit into pretty much any bra and have my nipples fit the cup in the proper 2 cm higher position, I have to really hike them up, then over the course of an hour, they slowly slide down again. I can rectify this by buying bras that are too small, but then I get that unattractive overflow at the top, not to mention being uncomfortably squished.
I may get a consult for an "awake" lipo procedure where liposuction is done with local anesthesia and the fat transferred into just the bottom poll area to stretch it. I guess after I get over my snit, I'll see about calling some offices in my area. Hubby is just somewhat annoyed that my boobies didn't turn out how I wanted them.
I guess I should have done what others on RealSelf did, explanting first to see how things turned out, then getting a lift to my specifications, and after that, getting a fat transfer. Live and learn from my mistakes, ladies!

I was silly to think I could just do a crescent lift. I read about other ladies experiences with those, including doctors opinion posts, and now realize I need to have an actual cut around my areolas to lift the nipples higher on my breast mound. That way, I could get from 2 to 3 cm lifted. Otherwise, I'll end up with a puckered flattened nipple complex with an oblong areola and starbust pattern scar at the top, which is how my previous donut lift ended up looking (gross).
The earliest consult I could get was in November, so I am totally bummed about that. If I hadn't argued with myself the past 3 months, I could have it done by now. I find it annoying that even in Covid times he is so darn busy! I wish previous needy patients could hop into a better position in line, but it's not like I am having a medical issue with the girls. I might as well just get a mammogram while I wait :)

Hi All, just wanted to give you an update on how I did after the FT revision to my left breast. I found that it did plump up the upper pole area enough, and filled in the inside cleavage a bit as well, but I did not notice any appreciable side boob increase. So either none was inserted there, or the graft did not take well. I have not checked in with my ps, as I am not only working from home full time, but have no desire to go out and catch Covid for vanity reasons. In my opinion, additional exposure additional risk.
I wanted to give my honest opinion of what I feel I could benefit from, and what I would prefer, if I go back for any procedure tweaking.
1) I have gained about 8 lbs to 123 due to less activity staying home and munching more out of boredom. That has increased my breast size to the point where they definitely fill out and sometimes spill over a full 36 B cup. I am more comfortable in a 34 C, but it depends on the style. I'm not sure I want to lose more than 3 lbs anyway, as my butt skin looks better with more weight.
2) I wish I had more lower pole fullness and/or a higher nipple position, as after the original lift, the top of my nipple was on average 21 cm from the bottom of the little V at the base of the neck, now they are about 23 cm, which I don't like. I blame my stretchy skin partially, although I had really wanted a higher look than was achieved initially, of 19 to 20 cm. I would still be okay with this result if it wasn't for the way I have to use my bra straps to "hike up" the nipple to fit all formed (and even non-lined) bras. After a short time, especially if my nipples get cold, I find that they are positioned under the spot where the bra assumes the nipple is supposed to rest. That gives them a weird side-view look of pointing downwards or giving the impression of sagging. Plus I dislike having to be vigilant. I just want to not have to think about it.
3) The liposuction for the FT removed most of the fat that I found objectionable along my waist side area and the upper abs. However, the days after the revision I mentioned an uneven denting or tethering after the lipo, but to be fair, the tethering was something that I had even prior to any surgery. I was hoping that it mostly resolve after wearing compression and massaging, but it did not. A lot of it is due to loose skin, but there is a small band of very firm fat (more likely) or scar tissue. When I wear tighter tops, it is noticeable, but mostly side view.
I have posted wish pics of what my breasts would look like with a 2 cm crescent lift of the top of the areola. I would prefer 3 cm, but that might leave too much skin puckering at the top - don't know for sure, but I suspect it, as that is what happened after my original BA donut lift, and took years to relax. You can tell from the pics that when I lift the nipple, the projection is slightly reduced, but that is a tradeoff and is only visible braless.
So, bottom line, I am contemplating the nipple lift, as the last thing I want to do is constantly be fiddling with and arranging my breasts in a bra. This would be an in-office procedure with only local anesthesia, which would be doable, as I draw a line in the sand at having additional general anesthesia at my age.
I have no idea on what to do with the denting on the front. I may have to live with that, as getting a reverse tummy tuck is not something I am willing to do.
Any and all opinions are welcome, or if any of you have had good correction results for any of the above issues I am having. Thanks!