Is an areolar reduction sufficient or do I need a breast lift? Or other? Please advise.

You suffer from a congenital condition on your breasts, named as tuberous or tubular breasts, constricted breasts, snoopy breasts, etc. There is a constriction ring at their bease limiting their growth in the puberal period, thus building them in a somehow tubular shape. One of their main features is the normally huge areolas, which need reduction, but there other remarkable features as a very high submammary fold, an odd conical shape, spiral glandular structure, etc.You need to find a real expert in this kind of breasts, a real congenital abnormality.Additionally you have some kind of ptosis (sagginess) which may or may not be treated with a vertical pattern (lollipop) Lejour's mastopexy, but this is absolute optional and would be chosen based in your own understandting of the pros and the scarred cons.You are not a standard or easy case, do seek multiple opinions.