Revision breast surgery
Thank you for your question. Need to see pictures attest before I comment. It may may not be possible. Please consult with a board certified PS for evaluation and to discuss your goals.
Breast modification after mastectomy and breast reconstruction is very individualized
With your history of mastectomy and flap reconstruction, you are in a special category for further breast modification. Standard procedures will not be possible for you, as any procedure that might be contemplated has to take into account the factors involved in your individual breasts, such as blood supply, tissue characteristics and distribution, implant sizes, symmetry, and the like. Thus, you will require a more complex plan than someone who simply needs a type of breast reduction with no history of prior surgery. I'm not sure exactly what you mean by "areola breast reduction," but if you are asking about a periareolar lift, or mastopexy, this may not be appropriate for your needs based upon what you are presenting here. My best advice is for you to find a board certified plastic surgeon with extensive experience in aesthetic and reconstructive surgery of the breasts, and preferably one who is comfortable with revisionary surgery as well, and schedule a personal consultation. That will be the only way that you can find out what the best options are to meet your specific goals. In addition to being certified by the American Board of Plastic Surgery, your surgeon should also voluntarily participate in the Maintenance of Certification program administered by that board. This is the best way to know that your surgeon not only has the best training and experience for the procedure, but that he or she has maintained currency in the certification requirements as opposed to practicing on a "lifetime" certificate which has only been reviewed once at the beginning of his or her career. For more information on this you can visit ABplsurg.org or ABMS.org. Good luck.