She had her breast augmentation done by another plastic surgeon using a periareolar incision. This is why her nipple are being pulled down by the internal scar tissue. This incision is notorious for this complication and resulting distortion of the breasts. Her breast implants are also above the muscle. This further distorts her breast shape from the breast implant scar tissue. She had all of the scar tissue removed and new breast implants placed. She wanted to keep them above the muscle despite the recommendation to consider a position change.