What Causes Nipples to Be Close Together After Breast Augmentation? (photo)

Positioning of th implants in the pocket below the nipples does change the relationship of the nipple areolar complex and the breast. In the patient on the right the implants are moved to the outside making the nipples look inwards. This can be corrected by moving the implants more inwards and upwards.

It looks like from the second photo that the implants may be displaced too laterally, but it is hard to tell with her pushing on her chest.

Please post more photos because I too agree this might not be the same patient. The post operative one view shows a lateral over dissection of the pocket causing lateral displacement. This gives a visual effect of inward pointing N/As. 

The position of the nipple areola complex on the breast mound pre operatively is usually a good indication of where they will be after augmentation. If they are uneven before surgery then they will be even more exaggerated after surgery. In situations where nipples are really uneven your surgeon may recommend to move one up to match the other. When the pocket is created for the implant and it is too wide such that the implants sit to the sides then the nipples may appear to be pointing inward. Likewise if the pockets are opened too much in the midline and not enough over the outer part of the breast then the implants will sit too much towards the middle and the nipples will appear to point outward. It is important to make an even pocket that allows the implant to sit right behind the existing nipple areolar complex so that they stay centered.

The  nipples  are close together because the implants are displaced too laterally and too low.this may be as a result of an excessively large pocket created during surgery or subsequent migration of the implant

In these cases I often use an adjustable breast implant combined with internal mesh support

The mesh holds the implant in position .The implant is then slowly filled after surgery under controlled conditions  to assure that the implant remains in the desired position