Advice on Revisions After Exchange Surgery

I had my exchange surgery on December 4th. I had had a double mastectomy in June. Cancer was on left side and had sentinal node removal on left side. Immediate expanders were put in. This was at the end of June. As soon as mastectomy was healing I could see there was a huge dent on my left side. With each expansion the expander moved above the dent and it was almost as if the scar was not allowing the expander to drop. My ps surgeon assured me he would fix this at the exchange surgery. Fast forward to December. He had to do a lot of work and my scars on each side go from inner breast all the way to my back. He took flaps of fat out under each arm hence the long scars. I was happy with that because on left side it felt like I couldn't put my arm down because of the fat being pushed by the scarring and dent in breast. It is kind of hard to explain. I will add pictures once I am added to the photo forum. He said the dent was from scarring (not sure how a scar formed immediately as it was there as soon as mastectomy was over) and extensive tissue being removed to get all the cancer on that side.

He was very optimistic though that the dent would be gone. I could tell immediately that a small dent was still there. It is just enough of a dent that you can see it with a t shirt or tight shirt on. I really was looking forward to not wearing a bra. I also went with the wrong size. I wanted to be smaller...I used to be a 42 D. Told him I wanted to be a C. I asked if that would look funny on me since I am 5 7 and 175-180 pounds. He said no. My implants are silicone high profile. As soon as I got home I could tell they were too small. They don't project from the side at all. I can live with that. I measured and according to my measurements I am a 42 AA. I wish so I had read the tips on here of what size to get BEFORE my surgery. Previously I was going to go with 3 d nipple so I could always go braless, but recently I did decide to do nipples because he told me that would help me fill out a bra and project when I went to see him for my one week post op check. He said the dent would continue to fill out and that all looked good. I went back again about two weeks ago and he still said all looked good and that the dent might still fill out. We went ahead and scheduled the nipple surgery for the end of January. I won't see him again before then. I really like him, but I just feel like he isn't taking the dent seriously. At least I know he isn't trying to just get money out of me and suggesting revisions already.

But anyway, the dent is still there and on the outer edge of scar under arm and toward my back there is a nipple like dog ear. It literally looks like a nipple. I hadn't noticed how bad it is until this week. Also when I lie down or bend over or sit a certain way the scar line on left breast folds in/indents all the way across like the breast is folding in half. The right breast stays up and smooth. Both breasts fall down to my underarms when I lie down like my old breasts did. I thought implants stayed up and erect. I can live with this falling to the side though because that is more realistic I suppose. They are spread apart also like my old breast. I can live with that too since I know sometimes the beast grow together and cause a problem. .

My main issues are: the dent and the folding of scar when I lie down or bend over and the nipple/dog ear on end of scar. My scars run across where the nipples will be. So basically on my left side when I lie down my nipple will fold in. He is doing my nipples in his office with just a numbing shot. So I know he won't be doing anything to fix the dent or the denting of scar across breast. I don't think he can even fix the dog ear on end of scar in office. He will probably have to do some kind of hospital surgical procedure to do any of those fixes. As far as he is concerned there are no fixes to be done, but I am going to call next week and ask for an appt to show him the dog ear and the folding scar line and tell him I don't think dent will fix itself. He has no idea about the dog ear or the folding. Also, I forgot to mention the scar on the left side is thicker and harder feeling than the right. My question to all of you is what will he do to fix these issues? what is usually done? Shouldn't I ask him to fix those issues before making nipples? I think the nipple will be in the way of him fixing the folding issue. Am I being too picky? Do any of you have the issue of your scar line sinking in all across your breast. To be fair to surgeon when I first met him I told him I just wanted to look good in a top, but I have to wear a bra to do that now to hide the dent and folding line. I also have to stuff my C cup bra to fill it out. I don't want to have to do that. I want to be able to just go braless or put on a bra and go. Any tips or suggestions or stories of how similar experiences would be appreciated and also what your doctors did to fix these issues. Sorry to be so long.