Reduction in May 2023, my nipples have been ruined. Correction options? (photos)

I don't think your nipples are ruined--what is happening is they are being pulled towards the outside of the breast because they are attached to the underlying tissue (pedicle) and that is falling down and out and taking the nipple and areola with it. It can be fixed by redoing the reduction and sewing the pedicle to the medial aspect of the chest and reducing the size of the pedicle to get rid of the weight. Obviously this would mean another surgery but it might be worth considering or at least discussing it with your surgeon. He is the best person to do this as he did the first surgery and knows where the blood supply to the nipple and areola are so it is also the safest way to do it.

As for the roll--it was there before but not in the same configuration and that's what has changed by lifting the breast the roll has just become more prominent but it is pretty normal so I wouldn't concentrate on revising it.

Thank you for your query. The pulling in and deformity of the nipples is because of scar tissue. The scar tissue can be released and autologous fat grafting can improve the look of your nipples significantly. Some liposuction on the sides will help with the “side rolls”. Rather than sagging of your breasts there is some “bottoming out” going on , the tissues moving down while the nipple-areola stay up. This can be corrected only by a revision of the procedure using a different technique. Please discuss your concerns with your Plastic surgeon who can help you or with another Plastic surgeon who is more experienced with these procedures. All the best!

From the posted photos it appears you would benefit from a revision to the lift. This would include correction of the nipples and a nice improvement is very possible. If you are no longer confident in your surgeon, visit with another board certified plastic surgeon in your area for a consultation.