Sometimes the implants settle to a position on the chest wall where they are too low relative to the position of the nipple.  This produces a breast profile where the nipples point skyward.  When looking at the breasts face on in full frontal view they have a "sad-eyed" appearance, this condition is called bottoming out and is usually corrected by placing tucking sutures at the lower edge of the implant pocket to raise the implant to a position where the center of the implant is directly behind the nipple.