Thanks for your question. Silicone implants tend to take on a more sloping or tear drop shape when in the body and under the muscle. Saline implants are more like water balloons so they have more fullness up top so less sloping.There are implants that have a teardrop shape to begin with (gummy bears). These have a thicker silicone and a rough surface so they stick inside and don't rotate inside you, but sometimes they can.In general implants do not create a puffy nipple, although in some cases the nipple may project more.Any natural sloping can be lost if the implant is too large. For what you seem to be implying I tend to favor a smooth round implant ( doesn't matter if it rotates), common sense size, and under the muscle.Hope this helps.
Reviewing your goals in person is key. You should bring some photos to show what you are trying to achieve.
