Rosendo Martinez, MD

It is difficult to answer your question without any past medical history. Some can become expose because they are place under the skin, without muscle coverage, other can become infected and been it self a foreign  body it can be extruded. If patient has had radiation treatments in the past the skin also can be affected and they can be extruded as well. If it did then one should wait at least six months prior to considering reoperation, and maybe even use a dermal matrix coverage, or latissimus dorsi myocutaneous flap or other type of coverage for the area.

It is difficult to evaluate just by photos. How long ago was surgery done? It seems that you have lack of upper pole fullness (superiorly) and saggy breast and rippling of the skin. This may need to be address by placing the implants under the muscle and doing a full  mastopexy.

Most time one week post op a breast may hurt more than the other just because the muscle could be in spasm, or it may be that it bleed some in the inside and/or it was more traumatized during the insertion and its just more swollen. If there is not significant size difference just having ice packs and some gentle massage may be enough, but if significant size discrepancy and pain you may have a hematoma. If so I would advice to contact your surgeon.

You have a wide space in  the anatomy between  your breasts  and also lateralization of your nipple- areolar complexes, the implants although they may filled in some area of the middle of the chest, if the nipples-areolar complexes are not move towards the center, it will make your condition worse.

I believe that if you have sensation in the nipples, it will be a matter of time( 6-8wks) before you should be able to have nipple hardening. What you have at present can be due to the incision site, local inflammation.Good luck