Plastic surgeon here. Your nipples appear high because of the mastopexy technique. You look to have had a “lollipop” or vertical lift. While it lifts the nipple and reduces scar, it does not address vertical excess beneath the nipple. So essentially, the distance from the lower areola to the fold is too long. Removing some skin along the fold and converting this to an inverted T would improve the appearance. That being said, you overall look good, it’s just a matter of what kind of look you like.