I had a nipple sparring mastecomy. With the expanders my nipples are always erect will that continue that way after exchange?

Thanks for your question. You will probably have less projection once
the softer implants are placed. The shell of tissue expanders is harder and
less flexible than that of breast implants, so your implants will likely not
push your nipples out as much. I suggest you express this concern to your
surgeon, who should offer some insight on what you can expect. It is not
uncommon for women who have undergone reconstruction, even with nipple-sparing
procedures, to later get adjustment procedures to their nipples. Best wishes
for your reconstruction.

Your may or may not have as much prominence when your implants are placed. Most of your ductal and breast tissue was removed and the expander may be indeed pushing out your nipple. If you are concerned about this long term, discuss with you PS a nipple shortening procedure which is simple and almost painless.