Would it be possible to have an areola reduction without a lift? (Photos)

Dear brooked244,thank you for question and shared photos. Your photos show a significant level of ptosis so a anchor lift and a lollipop is an option. I prefer performing a lollipop lift specifically for your situation to avoid the boxy look and excess scars.  You should visit a board certified plastic surgeon for a detailed examination and consultation. Areola reduction will not resolve problems with sagging. Daniel Barrett, MD, MHA, MS 
Certified, American Board of Plastic Surgery  
Member, Am. Society of Plastic Surgery

In order to accomplish the lifted look that you demonstrate in the photo with your hand you will need a lifting procedure. There is too much ptosis (sagging) to get a good result from an areola reduction alone. One option to consider is a lift with an autoaugmentation. This procedure uses your own tissue to provide upper pole fullness. This is different than a fat transfer. I've included a video that I hope you find helpful.

Thank you for the question.
Areola reduction  involves  circumferentially removing areola  skin  around a smaller areola design. This procedure can be done under local or general anesthesia. It is often  done as part of a breast augmentation/lift,  breast lift or breast reduction  procedure. If the areola are "puffy" (for example, as seen with constricted or tuberous breasts) some breast tissue excision may be helpful.
Patients should be aware that despite best efforts scarring will be visible and potentially abnormal ( possibly thick, raised and/or pigmented).  Some areola asymmetry may also  be present after surgery.   Their  is  a small chance that  a patient may lose sensation.
As with all plastic surgical procedures, patients must weigh the potential benefits against the potential risks/complications  while making decisions.
I hope this helps.

Here is the deal:Reducing the areola can be done with a periareolar donut mastopexy technique but if the difference between your current areola and desired diameter is significant, there is a risk of areolar spread or scar spread with that technique done alone. This means you are likely to get a better result by distributing some of the tension from being just around the areola to a combination of the areola and a vertical incision (lollipop). By the time you commit to these incisions, you are basically committing to the externally detectable components of a lift, so why not lift the breasts since you are a candidate for that? The lift does not have to significantly impact your potential for breastfeeding, depending on how the surgeon keeps the tissues attached to the nipple. You should get some in-person consultations to be educated with drawings on photos of your body or an anatomic atlas to explain the process so you can make a decision that makes sense.