Puffy nipples/areola reduction. Is there noticeable scarring?

You can elect to have areola reduction surgery as well as correction of puffy nipples (This is often related to addressing herniated breast tissue) prior to pregnancy. There will be an incision around the areola. Future pregnancy can impact your results which may lead to the need for a revision later on. See a board certified plastic surgeon near you to learn more.

It is important to know that the areola  scar  will always be noticeable (some  more than others). This may be because the scar heals with too much or too little pigment or because the scar is raised.You should also be aware, that areola  reduction surgery does carry  other risks such as spreading of the areola, asymmetry, shape irregularity etc.In order to avoid disappointment, it behooves you to be aware of the worse case scenario and, armed with that knowledge, decide if your dissatisfaction with the areola size justifies the risks/downsides associated with the procedure.I hope this, and the attached link, helps.

I
think you are speaking about areolar reduction here and this can be very
predictably performed with what the patients call the “donut excision.” This
involves two circles and the inner circle, the areolar size that you would like
to obtain and the outer circle is how much we would reduce and removing only
the skin in between. This leaves an incision that goes around the perimeter of
your new areola. Most of the time, the incision heals very well and we do a lot
to prevent noticeable scarring, mostly taping.