I myself am confused by the conflicting answers given to your question- so I'll try to clarify some things. First, it's very difficult to evaluate exactly what's going on in your case from the single photo you provided. In lieu of directly examining you, good standardized front and side photos would be required to give you specific information.
I see many cases of Tuberous breasts in my practice and most are minor. In some cases the nipple issues of tuberous breasts need to be addressed surgically to assure an acceptable result- but not always. The fact that your breasts are far apart is an issue usually seen with tuberous breasts, as the breast base is, by definition, narrowed. The fact that your nipples are angled so far to the side is, however, not part of what's typically seen with this condition.
The lateral (to the side) position of your nipples on your breast needs to be addressed if you are to have any sort of augmentation surgery- otherwise you run the risk of this being even further exaggerated from surgery...but, again, I'd need to see better photos to tell you this for sure. In a recent case of a patient undergoing breast augmentation surgery in my office, the decision was made to re-evaluate the breast shape, in the sitting position, once the implants were placed. The decision to treat the tuberous deformity was made by me during the surgery. Photos were taken so, afterward, I could explain the decision to the patient. Treating a tuberous deformity often requires additional scars on the breast which has to be part of the decision-making process.
You can feel free to post additional photos. I'm happy to then get back to you.
Good luck in your quest!!!...Scott Newman, MD FACS