Why Are my Nipples Facing Different Directions?

This is very common. "Drop and fluff" can happen faster in one breast than the other, and this is probably what is happening to you. Please wait for about three to four months for your breasts to settle before assessing your results. Best of luck!

From your photo, it appears that your right breast pocket is smaller, and I do see where your nipple looks like it is pointing down likely from the difference in pocket dissection.  I would recommend that you have a breast strap placed over just your right breast at the top of your breast for pressure, and to wear it 24/7 until they have evened out.  This will help strech the pocket while the tissues are still healing.  If you wait too long, it likely will not work.  This may not be 100% effective, but it can help alot.

It looks like the pocket for implant placement was dissected more caudally on the left side than on the right.  Sometimes, an Ace wrap (elastic bandage) placed above the higher implant will help to bring it down after surgery.  Sometimes it will not help, but it is ideal to exhaust all nonoperative interventions prior to operative ones.  Keep close contact with your doctor.  It is too early to judge your final outcome in 4 days.  If this were your result at 6 months, I would say that not much will change.  However, at this point, your result will continue to evolve for several weeks.  Good luck!