After your Premium topo is published, you can still add new routes and make updates to it.
You can add and edit any information on the topo, just like you did before the topo was published. All the additions will become visible to others.
This is true also for content suggestions. After you've accepted a suggestion by other climbers, it will be immediately visible to everyone.
If you think the quality of the topo has increased with the updates (you have for example added better topo images, added additional info to routes or improved the description) you can ask it to be re-evaluated. It's always better to do many updates at the same time before sending the crag to re-evaluation.
If you want your topo to be re-evaluated, just send an email to teemu(at)27crags(dot)com with the name of the topo and with an explanation of parts that have been updated.