Could doing a revision of the lift fix the size and uneven areolas/nipple placement? (Photo)

The areolae skin is the most stretchy part of your breasts. I agree with the surgeon who suggest smaller implants since less stress will be applied to your areolae. Yes, they can just be tightened, but they may still stretch out some because of the size of the implants.

Dear CGZ12,
breast revision surgery is the most difficult plastic surgery procedure performed. Botched breast surgery alters normal tissue planes and laxity, the ability of breasts to heal properly, and leaves scar tissue that dramatically affects the level of difficulty of the corrective surgery.Many patients come in to correct poor outcomes from their initial surgeries. The most common problems are due to implant malposition, bottoming out of the implant, poor scarring, and incorrect implant size.While the type of revision required will depend on the result of the previous surgery and the desired result of the patient, some revisions involve extensive pocket repair that may or may not need specialized external bras.If you are considering breast surgery revision, you should speak with a board certified plastic surgeon and have yourself properly assessed. Only after a thorough examination you will get more information and recommendations. Also, you have to make sure that your surgeon understands your breast augmentation goals.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

From your photos, I note that preoperatively you demonstrated significant bilateral sag and inward pointing nipple areolar complexes. There was relative symmetry of breast size.
The early postoperative view demonstrates an excellent result.
The later result demonstrates stretched out large areolae of different sizes and asymmetry of breast size.
This significant change in appearance suggests that your chest wall skin was quite lax, and as a result, stretched out over time, the implant was of significant size, or there was an intervening pregnancy.
Revisional secondary lift will decrease areolar diameter and improve symmetry. Also consider a smaller implant to prevent recurrence.
Best wishes...