Well, at first hand, you need more practice with the Photoshop Layers and Bloat tool for a smoother growth blend, rather than just selecting the titties and then trying to scale them. You'll always loose resolution clarity at that route. The bloat tool will give you more symmetry for the nipples if you know how to control it, where in this photo, the nipples are pointed everywhere but straight on as nature intended it. The Rubber Stamp tool on the bedframe could use more practice. You might want to consider enrolling in an Adobe class to hone your skills a little more.