Getting a BA, don't like how unnatural the shaped nipples look, they look so unnatural to me, are there other options?

You may have a component of what is known as a tuberous breast, which involves the breasts being constricted/tight, a short and tight distance between the nipple and the fold underneath the breast, and a large areola nipple complex. Doing a breast augmentation alone will do the following: 
1. Make the breasts larger 
2. Enhance the shape so the breasts are not as constricted/tight 
3. Lengthen the distance between the nipple and the fold
Usually after a breast augmentation the nipple-areola will get larger (probably around 25% larger). However there is no specific thing the surgeon does to "shape" the nipples during a breast augmentation. If the patient wants her nipple-areola to be smaller, then the surgeon can cut out some of it to make it smaller, but it will be fairly round in shape (this may be what you mean by "shaped"). So if you want to get smaller areolas, you would have to decide if you are willing to accept the rounder shape as a trade off. Most patients end up being pretty happy with this trade off, however. 
Seeing a plastic surgeon will allow you to get an in depth examination and then discuss treatment options and your goals. You would also be able to discuss your desired nipple appearance and review photos. 
Best wishes, 
Rohit Jaiswal, MD 
Plastic Surgeon; Las Vegas, NV 

Breast
augmentation would be inadequate.  Your
breasts are asymmetrical in shape, position and volume.  You would benefit from a breast lift more
than augmentation.  Women do not like
lifts because of the vertical scars associated with the traditional
technique.  For that reason, I recommend The
Bellesoma Method.  This will reshape your
breast tissue creating upper pole fullness without implants, elevate them
higher on the chest wall and more medial to increase your cleavage.  Vertical scars are avoided, nipple sensation
and the ability to breast feed are maintained. 
At the same time or later, fat transfers can be performed if additional
volume is desired.Best Wishes,Gary Horndeski, M.D.

Thank you for your question. Once you increase the fullness of your breasts, your nipples may appear more proportionate to the new breast size without the need to reduce the areola. If you opt for a periareolar incision to place your implants, the areolas may be slightly trimmed down when the incision is created as well – which may produce a more proportionate look without appearing unnaturally shaped. If your surgeon chooses to place your implants using an incision in the breast crease, you can leave your nipples alone until after breast augmentation to determine whether you are more satisfied with their appearance. If not, you can decide at that time if nipple reduction would be the right option for you. No matter what choice you make, be sure you select a credentialed specialist plastic surgeon with ample experience in breast enhancement. Good luck!  

There are several options to improve the shape and size of the nipples. You should have a consultation with a plastic surgeon for further evaluation. 

Congratulations on your upcoming breast augmentation, TXSTgirl19!I agree with you -- the "shaped" nipple following a breast lift generally does not look totally natural, regardless of how well the scar heals and fades, and there is a somewhat "pasted on" look. A "verticle" breast lift technique gives a more balanced, natural appearance of the nipple, in my opinion. Also, this technique has the potential to shape the breast to a more pleasing shape. I definitely don't like the resultant look of the nipples with a "donut" breast lift (except in unique situations such as a severe tuberous breast) that often is recommended to address just the nipples, and I have quite a few patients that come to me for revision. I would recommend that you look at photos of straight breast augmentations and augmentations with lift that you surgeon has performed in the past to help you decide. If you are still on the fence, you might also consider proceeding with just the BA and return for a breast lift at a later date if you are still unhappy with your nipples. Best of luck to you, and I hope you achieve the results you were looking for!  Dr. Ghafoori 

Hello,
With a breast augmentation, we don't usually reshape the nipple. However, if they do a areolar approach, they can do some minor reshaping. A breast augmentation will take your natural shape of the breast and nipple and enhance it, not necessarily change it. It is best to discuss these concerns with your plastic surgeon, so they can get a better idea of what you like and discuss what is achievable. Good luck!

You certainly may have an areola reduction to make the area lie smaller. Be aware the left breast is lower than the right and you may need a component of a lift to create better symmetry.