Had a breast reduction and now my areola and nipples are too high - what are my best options? (Photos)

I don’t think your nipples are too high. The problem is that the lower portion of the breast has stretched out, also known as bottoming out. This can be corrected by tightening the skin in the lower breast through incisions that are already there

Thanks for your question.
Weight gain and weight loss certainly lead to aditional skin laxity. In the short term a wedge of skin removed on the bottom of the breast will tighten the "lower pole" and to some extent pull down the nipple depending on the degree of upper skin laxity. You would look less droopy but only loose a few grams of skin so no real change to cup size. Over the long term gravity will win again and you may eventualy need to retighten. Wedge of skin is simpler, an internal bra would require reopening the whole breast.
If you want more fullness in the upper pole you will need an implant with enough diameter to sit at the fold of the breast and be tall enough to reach the top. As you note there will be a trade off because the implant will elevate the nipple somewhat. Your PS will have to help you find a balance. Based on your one photo, even with an implant, I think you will have some droop because you still have a good amount of natural volume which will always respond to gravity. I too think a little laxity looks more natural. Fat grafting in the upper pole is less predictible and may also give some nipple elevation.
You could do a lower pole wedge and implant placement at the same time through the same incision. I favor implants below the muscle as discussed in the link below.

Hope this helps.

I can understand your aesthetic concern with the appearance of nipples that are too high from the front. To fully evaluate your options and the true nature of your problem side photos would be needed to determine the location of the inframammary fold.

It may be that you simply have a bottoming out of the lower pole, and the appearance of your breast could be improved by revision of the lower pole of your breast and substitution with an implant for upper pole, fullness, if he desire the same size.