Unhappy with breast augmentation. What can I do? (Photo)

Your pre op photos show some natural asymmetries that are still present post op. This is expected as placing implants typically will not correct these. It appears that you have had a very good aesthetic outcome, but any concerns should be discussed further with your surgeon. There may be subtle changes that could be achieved through a revision, but i suspect that any anticipated benefits would not justify additional surgery at this time.

Your right nipple-areola complex was already lower than the contralateral side. This was exacerbated after placing the implants. A tight pectoralis muscle is not the reason for any of this. It might be due to too large of an implant and stretching of the nerves that are on that side. When placing an oversized implant, you can also sometimes damage the skin causing worsening scarring. Regardless, these are all my own opinions based on the photos provided. I would recommend seeing a plastic surgeon who has great training and experience in aesthetic breast surgery.

Only an in person exam will be able to tell for sure, however it appears that your left sided implant has bottomed out a bit. This could be fixed by inframammary fold fixation, which should be able to be done from the inside out from the previous incision. You could also perform a right sided scar revision as well if this scar is bothering you.