Dark pigmented spot on areola after mastopexy? (Photos)

This is probably related to internal scarring around the incision line but best to be checked out by your PS.

Obviously, the best person to pose this question to would be your personal plastic surgeon since he or she would know exactly what was done, what sutures were used, and where they were placed.  All that being said, based on the pictures you have shown and the history of what appears to be a well done mastopexy, my best guess at this moment is that your primary plastic surgeon used subcuticular dissolvable sutures, as most of us do.  Some of these sutures are placed close to the bottom layer of the skin, and what dissolves these sutures is the inflammatory process.  If this inflammatory process occurs near the bottom of the skin, hyperpigmentation over the area is not unusual, and as you can see, this hyperpigmentation may last a very long time.  If you were my patient, I would agree with your primary physician and tell you watch these areas closely but not worry too much.  In plastic surgery, there is an old saying that, "when you hear the sound of hoofbeats, think of horses and not zebras".  Anything other than hyperpigmentation from a dissolvable suture would definitely be a zebra.

A mastopexy or breast lift operation is designed to improve the
shape and position of the breast without reducing their size. It is used for
breasts which sag or droop (ptosis). Sagging of the breasts may occur with
normal development for some women, or as part of the aging process. Pregnancy,
breast-feeding and weight loss are other conditions which increase breast
ptosis. Some patients will have a better shape to their breast such as
increased superior fullness if an implant is used at the time of mastopexy. The
procedure can also be combined with a minor breast reduction to reduce the
breast width if desired. The surgery will create an elevated, more youthful
breast contour. Also, the procedure will create nipple and areolae of the
desired size and at the correct height.
I prefer to use a #shortscar technique, #LollipopScar or #DonutLift” rather
than the majority of surgeons in the United States that use an anchor pattern
lift which involve more significant scarring.If you find this is a concern, the best thing to do would be is to visit your surgeon to have the area examined and make sure that healing is progressing as it should.