3 wk post op, I am worried that my nipples will permanently be facing downward at the bottom of my breast and not in the middle.

I note from your pre op photos that the breast skin below your nipple is quite short and tight. This will take up to 6 months to stretch out and for the implants to drop. At such early stage after surgery, the swelling above the nipples also accentuate the fullness in this area. All these should improve over time. All the best.

and the gallery has spoken... give it time and in most scenarios, you will have a great outcome.  Keep your surgeon abreast of your concerns so interventions can be undertaken if deemed necessary as your surgeon is as motivated as you are for a great outcome.

At less than two weeks post-op your implants are high, and usually over time( about 3-4 months) they descend more in the pocket. Take a deep  breath and relax. If concerned contact your surgeon.

When we refer to implants dropping, we actually refer to a relaxation in the tighter lower part of the breast. This 'lower pole' will give and relax to accommodate the implant and your result should improve, and this will take several weeks. We like the use of a breast band over the top to encourage the process.

In general, your implants will drop to a point.  If you had smooth implants placed, these should be more mobile and your surgeon will likely ask you to begin massaging them.  The likelihood of having your implants drop will be higher.  If you had textured implants, they may not drop to the degree you may want.  The capsule adheres to the implant and they generally stay fixed in that position.  Speak with you plastic surgeon to ensure you have a proper plan in place.

You are very early in the post operative period still. It can take 3 or more months for your body to adjust to your implants. Your surgeon may recommend displacement exercises and or a breast strap to help your implants drop. Discuss your concerns with your surgeon at your earliest opportunity.

Thank you for the questions and photos.  It's still way to early to be concerned.  It can take 1-3 months for the implants to drop to their proper position. If you have smooth implants under the muscle, your PS will likely recommend massages you can do to get them to drop faster.  I give my patients an elastic Velcro strap to place at the upper part of the breasts to further speed up the process. 

It may take as long as 3 - 6 months for your swelling to resolve, your muscles to relax, and your implants to drop. Be patient and consult your surgeon.

it is way too early in the healing process to worry that your outcome won't be good. it takes months, not weeks, for this process to play out. your photos don't engender any undue concern at this early point in time. be patient and discuss it with your surgeon at followup visits.

Thank you for your question.  You are very early after your breast augmentation and your implants should drop and assume a better position beneath your nipple areola.  As the implants drop the nipples should be projected forward and as the implants gets below the nipple areola your nipple position should look much better.  Of course consult your plastic surgeon and ask if breast implant displacement exercises may be of help.