Will my breasts look perky? They are pointing downwards and I am quite concerned

Hard to answer this since you are only 1 month post op. Your implants still have some settling to do so this will change your overall look and shape. I advise my patients to wait a good 4-6 months to see their final result. If you still aren't happy after that time, best to have an open discussion with your surgeon! Good luck!

Thank you for the post.  As you mentioned, it takes several (at least 3 months) for your implants to settle into position.  Evaluating the size, shape, and symmetry (including the way your nipples look) before then is a bit premature.  It is of course reasonable to relay your concerns to your primary surgeon who knows the details of your procedure best.  From your photos, you appear to be healing appropriately.  I would urge patience before letting yourself get too worried!

I am sorry to hear about your concerns after breast augmentation surgery; although I understand them, I won't be able to provide you with the same degree of advice/reassurance that your plastic surgeon can. Generally, patients who start out with constricted/tuberous breasts may need to be more patient when it comes to viewing their final outcomes (after breast augmentation surgery) compared to patients who do not start out with these anatomic findings. Because the breast implants take time to "settle" into the relatively tight tissues of the lower breast poles, it may take several months (six months or even longer) before the final outcome of the procedure is achieved. In other words, patients undergoing this type of surgery should be aware of the need for patience and time before the lower breast poles "round out".  Also, generally speaking, as the breast implants "settle" into their positions, the nipple/areola complexes seem higher on each breast mound ("perkier"). At this point in your recovery, I would suggest:  ongoing time/patience and continued close follow-up with your plastic surgeon. I would not be surprised if you are much happier with the appearance of your breasts several months from now.  Best wishes.