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If your areola "sticks out" on one side after gynecomastia surgery, you should wait about one year prior to a revision. The most common cause of this problem is likely due to residual breast tissue just beneath the areola which was left behind at the time of your surgery, likely to avoid an inverted nipple. If the diameter of your areola is normal, then you don't need an areolar reduction, you need to have some more breast tissue deep to the areola removed. This can be done through an incision along the lower edge of the areola.
An exam is needed to know for sure, but from your description a revision to reduce the areola should improve your concerns. The puffy appearance can be addressed by removing herniated tissue and the shape of the areola corrected. See a board certified plastic surgeon near you to learn more.
Thank you for the question. Yes, areola reduction can be done, if necessary, after correction of gynecomastia. I have found that this would be the ideal sequence to do the procedures to avoid complications. Both of these procedures can technically be done at the same time. However I have found that correction of gynecomastia and areola reduction surgery done at the same time does carry increased risks compared to either one of the procedures done separately. This increased risk is related to decreased blood flow to the nipple/areola. Sometimes the areola shrinks enough with the gynecomastia surgery that the areola reduction surgery becomes unnecessary. I would strongly suggest that you make sure you are working with a well experienced board-certified plastic surgeon. Best wishes.
Areolar reduction could be done at any stage. However, I would wait for 6-12 months after surgery to allow for resolution of the swelling and to allow for healing.
From the submitted photo you appear to be a good candidate for the areola reduction. At this time a mastopexy is not needed. You can consider an areola reduction now and still get a mastopexy after pregnancy/breastfeeding if needed. See a board certified plastic surgeon near you to learn more.
An areola reduction is a procedure that involves an incision that goes around the circumference of the areola in order to downsize it. It can sometimes be performed in an office surgical suite under local anesthesia. Sutures are used to close the incision and will require minor home care. The...
Limiting the incision (and resultant scar) limits the amount of nipple/areola reduction and skin tightening that can be done.   It has been my experience that an incision around the nipple can reduce the areolar diameter by about 1/3 or it can lift the areola about 1/2 inch.  It...