Bottoming out, skin laxity or fat graft absorption? (Photos)

I underwent a mastopexy with a 285 cc high-profile breast implant, internal bra support using an internal suturing technique, and fat grafting (June 2025) Initially, I noticed a depression along the vertical incision area of my breast. I thought it might be due to fat graft absorption, so I went back to my plastic surgeon. He said that it was nothing to worry about and that it was simply due to some of the fat graft being absorbed, and that I could have additional fat grafting to the breasts later. However, after looking at my breasts more carefully, I noticed that my nipples seem to be pointing upward and that the upper pole appears to have lost volume. I am concerned that this could be bottoming out. Even though I had an internal bra using an internal suturing technique, is it still possible to develop bottoming out? Could this be related to the fact that my breast skin is thin? Would additional fat grafting alone be enough to correct this, or would something else need to be done?