The two sides of this issue are the one that says that there is a "perfect" location at which breast implants SHOULD sit on a woman's chest, and the other which says that "to each his own." Along the lines of the first, I can tell you that a recently published article in the plastic surgery journal looked at just this issue. While this is admittedly a subjective thing, the authors of the study asked all people from all over the world to "rate" the appearance of breasts with breast implants, and they found that the "ideal" location for breast implants was with the nipple just slightly above the midpoint of the height of the implant on the chest wall. In other words, the majority of those people who were asked seemed to think that the lower pole of the breast should be just slightly fuller than the upper pole, and the nipple should be just slightly above the midlevel line of the breast mound. The second school of thought pretty much says "to hell with all of that, I like what I like." I have had a number of patients request results which to them were beautiful and made them happy, while I, or someone else, may not have agreed with their aesthetic judgment. To me, a happy patient pretty much means a good result so long as there aren't any medical dangers or problems that are unnoticed. At 18 months after your surgery, your results are pretty much what they will be long term; I would not expect any further changes at this point. If there is something that you would like changed, that is a valid concern, and if it can be accomplished with reasonable certainty, I think any surgeon should listen to you. If you don't feel as though your previous surgeon is sensitive to your needs with respect to either implant position or size, it is fair to visit with another surgeon and get another opinion. Sometimes the things we want aren't possible, but if they are, I think it is reasonable to pursue them. Good luck.