It is not unusual to have some degree of asymmetry to the breasts as in your case. Although the right nipple areola is larger than the left with some herniation they are not truly tubular . A differential augmentation through a peri areolar approach with a periareolar mastopexy would correct both problems nicely. This would correct the asymmetry while making the areola flatter and smaller.
Breast augmentation to improve the size discrepancy would be reasonable. The areola can be reduced as well as the puffy areolar appearance.
board certified plastic surgeon who performs hundreds of breast
augmentations each year. Then look at the plastic surgeon's website
after photo galleries to get a sense of who can deliver the results.
Kenneth Hughes, MD
Los Angeles, CA
You likely have some degree of tuberous deformity, though a physical exam would be required to know for certain. Constriction of the lower pole, asymmetric size of breasts, and differences in the nipple-areola complex are all associated. Regarding one nipple being larger and closer to the fold, this can be due to herniation of breast tissue or due to an unusually high fold. It's difficult to tell from your photographs which is the case, but this is a condition that affects a significant number of women. If you are bothered by the appearance of your breasts, go see a plastic surgeon and voice your concerns. Find out what your options are and get beyond that appearance so you can focus on other areas of your life. Hope that helps.
But obviously asymmetric. The solution may involve reducing your areolar diameter and an augmentation using different sized implants. Your surgeon may suggest you stage your procedures which I think is often a good idea. I would also plan for a revision of some sort as patients with asymmetries often need a small "touch up" down the road for better symmetry.