If you're considering an areolar reduction, this can be done under local anesthesia.
The diamater of your new areolar is measured using a circular metal device referred to as a "cookie cutter". Once the smaller inner circle diameter is determined, the outer "excess" skin is removed then a permanent suture, such as Gore-tex, can be used to create a smaller, long-lasting diameter areola. The final layer of stitches are absorbable. This can be done in less than an hour with very minimal downtime.
Please see a board certified plastic surgeon to determine the best procedure for your specific case.