How long does it take for the "puffy" look to permanently go away resulting in a flat areola after implants + areola reduction?

The circular incision around the areola not uncommonly causes prolonged swelling. The swelling seems not to reach the edge of the areola, however. I wonder, therefore,  if the cause is not a Gortex suture that some surgeons use to control areolar size. I think that the areolars are large enough and the scars noticeable enough that a revision may do you well. I would suggest considering conversion to a vertical lift. Although the vertical scar will be added, the procedure will provide better control of areolar size, and with less tension on the closure, the scar should heal better.Discuss with your surgeon. All the best.