Why are my nipples pointing down and not centered post breast augmentation? (Photos)

I disagree, very firmly, the solution is not being strapped with a useless band, being braless or other peculiar ideations like waiting longer time or going for smaller implants, unacceptable; your implants were placed too high, totally under the muscle, they suffer dinamysm when you contract the pectoralis, the nipples are eccentric from them, the lower pole of the breast is more than empty but nonexistant, you have side boob deformity and over expansion of the prosthetic pocket at the side of the breasts, the cleavage gap is too wide and the look is round and fake because they are not anatomical; this result is very poor and is aggravated by the fact you are very slim and transparent.Breast augmentation in skinny and transparent patients is demanding of high grade from perfectionism, otherwise any minor imperfection is noticeable and boosted by the lack of cover.Following the link below you can see dozens of cases chosen by being "skinny breasts" enjoying awesome results; all operated with anatomical shaped cohesive gel filled and macrotextured implants placed in the subfascial plane, many of them are revisions, other primary cases, the same or even skinnier than you. Some of those cases are like clones of your anatomy and/or your revision case.Seek better opinions and the help of a surgeon expert in difficult augmentations and revisions.
If you wish better grounded opinion well lit, focused and standard images have to be assessed: frontal, both lateral and both oblique views, also from underneath.
Feel free to request any additional information from me.

Dear Jaqui52Thank you for your questions and photos !  Your implant position is high compared to the center of your breast and inframammary fold.If the implants are under the muscle - it may need a little more release.With Warm RegardsTrevor M Born MD

At size 32, each 100 cc of implant corresponds to 1 cup size change.  325 cc implants are large and took you up 3 cup sizes.  At this time, you alternatives are smaller implants or release the inferior pole of the breast.  Releasing the inferior pole of the breast can result in bottoming out and the breast will descend.  I recommend a modified Benelli lift with smaller implants.  Using a circumareola approach, the nipple is raised higher on the chest wall, the breast tissue is reshaped, elevated higher and more medial to increase your cleavage.  Through the same incision, smaller implants can be placed.Best Wishes,Gary Horndeski, M.D.

Skin stretches.  Ask any woman who has ever been pregnant, and the force needed to stretch the skin between the nipple and inframammary fold comes from time, gravity, a bando, and no bra no bra no bra.Although it appears that your surgery was done in an excellent fashion, you apparently did not wear a bando which creates downward vectors of force, and you did wear a bra sometime early after the surgery.  The combination of these two force producing garments kept the tissue between your nipple and inframammary fold from stretching out.At this point, your body has formed a capsule around the implant which tends to hold the implant in place.  All this being said, if you were my patient at this juncture, I would ask you to wear a bando 24/7 and not to wear a bra but nipple covers (for modesty).  The pressure from the bando and the lack of upward forces from a bra is your best non-surgical maneuver at this point in my opinion.

Thanks for your inquiry, massage and a band are good ideas to try, your surgeon should be the resource on how much massage, and recommendations on the type of band to wear. Not sure if this will move the implant enough though, good luck.

Thank you for your question.Usually after 6 months the implants should have drop more and be more centered behind the nipple. But for some reason they seem to stayed high. A correction can be useful to lower the position of the implant. Please consult your surgeon for advice and he/she may be the best one to explain and fix want you don't like about your implant.Best wishes
Dr Genevieve F.Caron, Board Certified Plastic Surgeon
Montreal, Canada

It does appear that your implants are a bit wide and did not fully drop into the pocket.  Generally the implant will settle lower over time. After 8 months though I would agree that your result will need to be revised to make you happy. Be honest with your surgeon about what you want to accomplish. This will likely require lowering the implant or changing to a different one all together while adjusting the pocket. If you are uncomfortable with your surgeon please consult with board certified plastic surgeons until you find one that you feel comfortable wit hand who has experience with revision breast surgery.

From your photos, it appears that your implants are both too narrow and too high. The best treatment would be to lower the implants so that the nipple sits centrally on the breast. However, if you go smaller, you will also lose even more cleavage - as you are already too widely spaced between the breasts. You do have the option to change to a moderate profile implant that will give you more width for the cleavage, but also soften the upper pole slope that worsens the appearance of the downward direction of the nipples.No band or garment will change the position of the implant this far out from the procedure. You should see a board certified plastic surgeon in your area to get a formal opinion through an in-person consultation.
Best of luck,
Vincent Marin, MD
San Diego Plastic Surgeon

Thank you for the question.
Generally speaking, breast implants will "drop" into the pocket that was created during surgery. The rate of breast implant "settling" may depend on factors such as size of breast implant pocket dissected, tightness of the overlying skin/muscle layers, and size of breast implant utilized. Normally, it takes about 3-6 months (for some patients longer) to see the final result.  As the breast implants "settle", the lower breast poles will round out, and the nipple/areola complexes will seem to sit higher on each breast mound.
I find that the most important variable, when it comes to exactly how far a breast implant will "settle" is exactly where the breast implant pocket is dissected.  Other variables, including the use of bands or bandeaus, will not change the outcome significantly.In cases where implants fail to descend and/or significant breast asymmetry persists, the pros/cons associated with revisionary breast surgery (for example, capsulotomy surgery for an implant that is sitting too high) should be carefully considered prior to making decisions whether or not to undergo further surgery. 
 Best wishes for an outcome that you will be very pleased with.