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

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.