Thank you for the question.
It would be much better to give you precise advice after direct examination. However, I will try to address all 3 of your concerns in a generalized fashion:
1. In regards to breast implant size: communication with your plastic surgeon will be critical to help you achieve your goals with the breast augmentation procedure.
In my practice I find the use of goal pictures to be very helpful. I have found that the use of words such as “natural” or “C cup” or "fake looking" or "top heavy" means different things to different people and therefore prove unhelpful.
Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup size may also be inaccurate.
I use intraoperative sizers and place the patient in the upright position to evaluate breast size. Use of these sizers also allow me to select the breast implant profile (low, moderate, moderate plus, high-profile) that would most likely achieve the patient's goals. The patient's goal pictures are hanging on the wall, and allow for direct comparison.
I have found that this system is very helpful in improving the chances of achieving the patient's goals as consistently as possible.
2. Inverted nipples can cause functional problems for women and emotional concerns. An inverted nipple can look flat or a slit like depression or hole at the normal nipple location. There are different degrees of inverted nipples possible. Whether a patient is a candidate for correction of inverted nipples depends on the extent of the problem.
Usually correction of the inverted nipples involve division of the lactiferous (milk ducts). The risks of the procedure include potential loss of sensation, inability to breast-feed, recurrence of the asymmetry and the potential need for further surgery.
My advice to patients go something like this... If the nipple is permanently inverted and does not evert with stimulation, then it is a useless nipple when it comes to sensitivity and/or breast-feeding. In these cases correction of inversion is indicated (because the potential gains outweigh the risks outlined above). On the other hand, if the nipple does evert spontaneously with or without stimulation, then I am more reluctant to perform the procedure given that the risks may outweigh the potential benefits. At that point, the decision is the patient's to make after careful consideration.
You should also be aware, that on occasion, nipples do evert after breast augmentation surgery ( if not, nipple inversion surgery can be done at a later date under local anesthesia if necessary).
3. Areola reduction surgery may be very effective in reducing the size of the areola. However, this procedure may be associated with unsatisfactory results. For example, you may find that the breast profile is flattened after this procedure.
It is also 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 information decide whether to proceed with the procedure, or not.
I hope this helps.
Best wishes.