My Breast Don't Look Round? (photo)

Without seeing your preoperative pictures or knowing your measurements it is hard to accurately comment (but I will try). The first picture with your arms down looks like a good result. The volume symmetry looks good and the position is appropriate. Your scars have faded very well. With your arms up there will be a tendency for the implants to move laterally. Saline implants have to be filled more to keep them from rippling and so they have a rounder appearance. It looks like your implants are fairly wide for your chest. The path of least resistance is lateral and so implants might tend to drift laterally. I don't think there will be a lot of change in position since you are 8 months out. By combining the augentation and mastopexy it introduces more variables and healing can be different. I would not suggest doing anything at this point. No one has mirror image breasts. I bet if you go back and look at your preoperative pictures you will be able to appreciate your result. I think you look great. If it is the feel you don't like then you could consider switching to a silicone implant.

  After a breast augmentation and lift, the contours at the lateral extent may be improved with a pocket revision and capsulorrhaphy.   However, a physical exam will be necessary to determine the appropriateness of this intervention.  Making a tighter pocket while keeping the same volume implant tends to put more pressure on the repair and increase likelihood of failure. 

Generally speaking your result is acceptable but not great! You have over dissection of the lateral pockets and thus lateral displacement of the implants. Only a revision via a capsularraphy with acellular dermal matrix or cautery effect can resolve the issue.