Hello and thanks for your question. It's difficult to say exactly what the shape and nipple positions are doing post operatively. From your photo, it looks like the implants are reasonably symmetric, but you have some breast and nipple asymmetry, which may have been present before, but exacerbated by the increased volume. I recommend that you ask your PS about their opinion, express your concerns, and have them carefully review your preoperative photos. If your nipples are at different positions, it will be difficult to keep the implants symmetric. Typically, I aim to center the implants on the nipples in most cases of mild asymmetry. We are naturally drawn to look at the nipples as landmarks on the breasts and the curvature of the breast looks best when the nipple is at the most projecting portion of the breast mound. However, if you have significant asymmetry, you may need a procedure such as a small lift or areolar contouring to make things match better. Hope that helps and good luck, Christopher C. Chang, MD Washington DC, Maryland, and Virginia