Areola reduction. Can this be done in the office? Could I do it right away? (Photo)

You have several issues going on here.  The reduction of the areola will allow for symmetry and a more aesthetic areola but realize you do not know how you scars will heal for 6-12 months- they may ultimately become barely perceptible, thickened, dark, or very white.  I personally think that smaller areola are more aesthetic and with the  reduction you should be able to achieve symmetry as well.  The issue of the breast tissue sagging down will likely be helped but it appears as though you had a sub muscular implant rather than a summary implant so this problem will not be fully resolved by areolar reduction.  A sub muscular implant does not fill the subcutaneous pocket fully, especially if the muscle is not fully detached.  The nerves will take up to a year to recover and sensory nerves can recover for a life time, so you do have potential for the normal response of your nipples that you had previously to return to baseline, but it may not.  This is the risk of surgery in this area.  The bumps are the ducts for the breast milk so if you remove these you will interfere with your ability to breast feed. Everyone has these, they are normal.