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

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.

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.