Downward-pointing nipples and overall poor breast form. What surgery should I be looking into?

hi and thank you for your question it is very difficult without a photograph to make a an appropriate comment however by the sounds of your description you are likely to have tuberous breasts for which there are common forms of treatment it would be best to arrange a consultation with an accredited plastic surgeon for appropriate advice. good luck

Thank you for your question.  A photo would be very helpful here. From your description you may have sagging breasts or tuberous breasts.  It sounds like a breast augmentation with a mastopexy may be needed.  Please contact a board certified plastic surgeon for an in-person consultation so that you can be better advised.  Good luck.