My breasts are wide set and my nipples point outward, will an augmentation exaggerate this? (photo)

You are a good candidate for breast augmentation however, based on your photos I think breast augmentation will exaggerate this - you should keep this in mind. Best of luck.  

Thank you for the photos. For the most part, breast implants are round. When placed under the breast they stretch maximally at the center and have less volume (and stretch) at the edges. This has the effect of raising the skin at the center of the breast implant the most, and pushing the skin near the edges of the implant out radially. Your nipples are very lateral, so the center of the breast implant will be well inside the position of your nipples. When the implants expand your breasts, they will tend to make the nipples look more lateral. The closer together the implants are placed, the less projection will be provided behind your nipples and the more lateral they will look. On the other hand, if the implants are placed farther apart, the nipples will be a little more centered on the breast mound (better out of clothing) but the gap between the breasts will be bigger. A smaller gap will look better in clothing, but the nipple placement will look worse.It is hard to tell from the photos, but your nipple/areolae appear puffy in the left-most picture. If this is the normal relaxed shape of your breasts, this will likely continue to be the shape after breast augmentation. Puffy nipples are often corrected with a peri-areolar lift. This type of lift could also be used to move the nipple up and more toward the middle. This type of lift cannot move the nipple very far, but it could help. If you do not have puffy nipples, the lift could still be used for nipple position. If you do, it could help both issues.When you choose your Board Certified plastic surgeon, be certain to ask them the questions you are asking here, and go through all your options. A lift can always be added later if the nipple position is bothersome, but it is worth discussing this option before your breast augmentation. Breast lifts are often used to reposition the nipple/areola complex higher on the breasts, and I have included a link with some example. Best of luck to you. 

Without an examination and knowing your breast measurements it's impossible to give completely accurate advice but I'm happy to hear you are looking for before photos that start out with your current breast/body shape. All too often women come in wanting a certain outcome but this may be unrealistic depending on their body type. I believe whether an augmentation is right for you completely depends on your goals. If you want to look better in clothing or a bathing suit implants will give you what you want. I don't think implants will worsen your current nipple position but just know that your breasts are spaced wide and implants won't fix that but will give your breasts a better shape and fulness. I would recommend textured implants and minimal dissection laterally to help minimize lateral displacement of your implants but your breasts will be more lateral than a typical breast augmentation patient.  Thank you for your question and hope that helps some. 

Upon
looking at your photos, I do agree that your nipple areolas are located on the
lateral aspect of your breasts. In
performing breast augmentation, an implant needs to be placed under the center
of the breast. Therefore, the breast
implants will be separated and I do believe it is possible that the direction
of your nipple may be exaggerated by the placement of a breast implant.

and implants will exaggerate what you are concerned about.  If you try to put the implants lateral, you will have a huge gap between the mounds and if you try to diminish the space medially, your nipples will rotate outwards.  Moving your nipples is an option but should only be done if absolutely necessary.  My personal preference would be to have the augmentation designed to make the mounds closer together then decide if you must move your nipples with the associated risks inherent with that.

Usually breast implants magnify the issues that were present. If the nipples are off to the sides or lateralized they will stay that way and may look more so.

Width is the most important part of choosing an implant. I always choose the size for a patient based on the width of their chest and breast.  You cannot move your nipple position so making sure the implant width matches is important.When the width of the implant fits your chest / breast width, they look nice and provide good cleavage without extending too far into your underarm. The implant will need to be placed appropriately so that the nipple position does not appear to look outward. If the implant is placed too medially, then yes, it can make them look outward. The implant should be centered behind the nipple to optimize their appearance.

Yes there is a good possibility that enlarging the breasts could result in exaggerated separated result appearances.... 

Thank you for the question and pictures.  Based on your photograph, you may be an excellent candidate for breast augmentation. The separation between the breasts you mention is clear; keep in mind that your result will be limited to some degree by your starting anatomy. However, careful breast implant pocket dissection and breast implant size/profile selection will help improve the appearance of the "cleavage area" to some degree.  Despite your good description of goals, online consultants will not be able to provide you with specific enough advice to be truly helpful. Ultimately, careful communication of your goals (in my practice I prefer the use of goal pictures, direct examination/communication in front of a full-length mirror, and computer imaging)  will be critical.Generally speaking, the best online advice I can give to ladies who are considering  breast augmentation surgery ( regarding breast implant size/profile selection) is:1. Concentrate on choosing your plastic surgeon carefully.  Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you are looking for. Ask to see lots of examples of his/her work.2. Have a full discussion and communication regarding your desired goals  with your plastic surgeon. This communication will be critical in determining  breast implant size/type/profile will most likely help achieve your goals. In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as  “natural” or "C or D cup” etc means different things to different people and therefore prove unhelpful. Also, as you know, cup size varies depending on him who makes the bra; therefore, discussing desired cup  size may also be inaccurate.  Again, the use of computer imaging has been very helpful during the communication process, in our practice.3.  Once you feel you have communicated your goals clearly,  allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals.  Again, in my practice, this decision is usually made during surgery,  after the use of temporary intraoperative sizers.I hope this (and the attached link, dedicated to breast  augmentation surgery concerns) helps.

You really should consider performing a mini-lift and breast augmentation combination. The lift will allow you to move the nipples up and to the center of your breasts which will then allow you to fit an appropriately sized implant to get you the volume you need. Getting an augmentation only would not work on you! Please refer to link below to see results that you can obtain wtih a simultaneous lift and aug