Decrease the Size of Areola Without Mastopexy?

Certainly you can have periareolar reduction, and careful technique can yield good results. But large areolas cannot be made too tiny, as the circumference of the present areola must be purse-stringed to the new smaller circumference. So there are limitations, and no surgeon, "special sutures," or surgical technique can ignore the rules of dimension. Too much discrepancy equals scar irregularity, with pleating or puckering that can lead to poor healing and a potentially wide or unsightly scar. What if you decide you don't like the scar, and in fact hate it worse than your present appearance? There is no going back, so I would advise caution. In fact, I might be so bold as to ask why you think your breasts, which appear very pretty in your photo, have a "poor look and shape" and make you want a "smaller and more youthful" look?

You are certainly entitled to feel any way you want about your body, but you may be overly sensitive about breasts that are not only perfectly normal, but really nicely full and extremely attractive for any woman. Best wishes! Dr. Tholen

From the submitted photo you appear to be a good candidate for the areola reduction. At this time a mastopexy is not needed. You can consider an areola reduction now and still get a mastopexy after pregnancy/breastfeeding if needed. See a board certified plastic surgeon near you to learn more.

Thank you for your question.
Yes, you can reduce the size of your areolas without a mastopexy (breast lift). This can be done through a procedure known as areola reduction surgery. During this procedure, excess skin around the areola is removed to make it smaller and more proportionate to the rest of the breast.
The surgery typically involves a circular incision around the areola, where the surgeon removes a portion of the surrounding skin and tightens the area with sutures. This procedure can even be performed under local anesthesia or with sedation, and the recovery time is usually short, often with minimal scarring that fades over time.
However, there are some considerations to keep in mind:
Scar: There will be a scar around the areola, which is usually well-hidden by the pigmentation, but it's permanent and cannot be completely removed.
Limitations: There is a limit to how much the areola can be reduced, and in some cases, reducing it too much can affect the appearance of the breast.
Pregnancy: If you plan on having children in the future, keep in mind that pregnancy can cause your areolas to stretch again, potentially requiring additional surgery later.
It is important to consult with an experienced plastic surgeon who can customize your surgical plan and determine the best technique for you based on your individual anatomy and goals.
Krishna Vyas, MD, PhD, MHSHarvard, Hopkins, & Mayo Clinic Trained Aesthetic Plastic SurgeonNew York, New York

If you are only concerned about the shape of your areolae, then areola reduction surgery may be a suitable option for you. This would reshape/resize the areolae to make them proportionately pleasing.

In your case since you do not have very large breasts that are heavy, you may be a good candidate for areolar reduction.  However, you need to understand that doing this procedure in breasts like yours is a type of mastopexy. It’s just that the incision is circular rather than lollipop or anchor-shaped.  It would give you a lovely result for a while. After a certain period of time, or with changes in weight or pregnancy, the areolas are likely to widen again. 
In your case, there is also a limit to how small they can be made.  If you want them much smaller, there is no way to do this without additional incisions being made where more of the pigmented skin could be taken. 

Thank you for your question.Areola correction is a local anaesthetic procedure unless it’s combined with a more complex breast surgery that requires a general anaesthetic. Prior to surgery our plastic surgeons will assess you and your desire to achieve the look, shape, size and symmetry of what you are looking for.On the day of your surgery our cosmetic surgeon will measure your breast height and various distances from your areola as well as the diameter of each. We make marks on your breasts while you are sitting upright and then numb the area with small amount of local anaesthetic.Extra areola skin can be removed to achieve the desired look and position. The scars are very fine and heal quickly and fade over time. In some people the scar can be touched up with medical tattooing to hide the visible signs of a surgical scar.Simple dressing is then applied before you are discharged from the clinic. You can resume daily showers and are expected to see your plastic surgeon in a week to check the wound.Please make sure you find a reputable and qualified plastic surgeon who can assess you properly to give you a realistic idea of what outcome you can achieve.All The Best