Nipple positions too close after a breast reduction. What are my options?

It is likely that this can be improved with a revision.  Often excising skin above the inframammary fold tightens the lower pole of the breast, shifting tissue higher resulting in more upper pole fullness and a more central location of the nipple.  If your areola is visible in bathing suits, sometimes the areola diameter can be reduced.  Having the nipple too far medial is more difficult to correct but often small adjustments can be made that can improve the appearance.  I would suggest either revisiting your surgeon to discuss this matter or considering consultation with another Board Certified Plastic Surgeon with significant experience with revision surgery.  Best of luck!

The skin envelope can probably be reoriented to lateralize the areolae and improve symmetry.Kenneth Hughes, MD
Los Angeles, CA

Hi tashanon.
I am sorry to hear of your disappointment post breast reduction.
Although breast reduction is primarily a procedure of functional improvement (by reducing the weight and size of the breasts and therefore reducing neck/shoulder/back pain), the cosmetic outcome is just as important to optimise.
A high nipple is difficult (almost impossible) to lower. Having said that, the cause of an optically high nipple may be "bottoming out" of the lower pole tissue. That is, the tissue under the nipple has dropped. One can do a wedge-type reduction of the tissue here, in order to place the whole breast mound higher on the chest. Although this manoeuvre does not actually pull the nipple lower, it looks more central relative to the whole breast. 
In terms of  medialization of your nipples, its difficult to give suggestions on this without seeing a photograph. Please communicate with your plastic surgeon your concerns. I am sure he or she will try to improve things for you if possible.
All the very best.
Dr Ray Goh