From that you picture, you can see that like the service the girls gives to the guys, there are good plastic surgeons, and some not so good, which is why the nipples are at an unnatural angle.
A close friend had breast enhancement, and the surgeon (a top English surgeon) spent several consultations discussing the size of the implant, trying various sizes, and making sure that she was going to be happy with the end result, and that it was in proportion to the rest of her body.
She also went on recommendation, not bothered about cost, just wanted a first class job. Far too many girls go to cheap surgeons, have implants that are far to big and wonder why their nipples face the sky ! A good job costs around £4000-4500 with aftercare included.
And how many save money for the replacement silicone, usually 10 years down the line?