I have large areolas, lack of tissue in the lower pole, what are my options? (Photos)

If you are okay with the size of your breasts, as you state, then your areolas can be made smaller and lifted surgically. This could accomplish your goal.Dr. Ted EisenbergBoard-Certified Plastic Surgeon and Author

Hello and thank you for your question. You are a great candidate
for a breast augmentation with an areolar reduction.  A dual plane technique can be used to help with your lower pole.  Make sure you
specifically look at before and after pictures of real patients who have
had this surgery performed by your surgeon and evaluate their results.   The most important aspect is to find a
surgeon you are comfortable with. I recommend that you seek consultation with a
qualified board-certified plastic surgeon who can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon