Can my nipples can be moved to a more cisgender position? (Photos)

Thank you for your question. I rarely reduce the nipple at the time of the top surgery b/c you don't want to jeopardize the blood supply. However, reducing the projection of the nipple i.e. how much it sticks out, is easily done in the office.

Based on your photos, you are a very good candidate for a keyhole incision and a nipple reduction, both of which can be done at the same time. Doing even keyhole surgery under local is fairly difficult, as the tissue that is removed is in a fairly wide area, and this can be difficult to completely anesthetize. You can discuss with your surgeon whether or not this can be done under sedation, but again, sometimes it is easier and safer to be completely under general anesthesia so you do not move inadvertently during surgery, as can happen when someone is just under sedation. Best of luck with your surgery!

In general I wait for about 6 months after the peri approach to allow the nipple and areola to shrink after the breast tissue is removed.  If the nipple is still large, then I go ahead and reduce the nipple size.  In your case, however, there is not a lot of breast tissue so I am not sure your nipple itself would shrink after the breast tissue is removed.  It would be reasonable to make it a bit smaller at the time of the peri approach if you are unhappy with it.  In regards to the actual position of the nipple areolar complex on your chest, it is very hard to predict where it will sit when the breast tissue is removed.  It usually goes straight back onto the chest in the location it was pre surgery.  Hope this helps.
Dr. G