Are my areolas abnormally large and do I have significant sagging? (Photo)

Thank you for sharing your question and photographs.  Aesthetics is in the eye of the beholder, but overall your areola are well proportioned to your D-cup breasts and it does not appear that you have much sagging taking place. Sagging is based on the position of the nipple and areola relative to your under breast crease.  Your nipples appear to be above this line.   If you have concerns, schedule an appointment with an ASPS board certified plastic surgeon to discuss.  Hope this helps.

In order to determine the degree of sagging (ptosis) an exam or photo of you with your arms at your sides is needed. The size of the areola does not seems significantly out of balance with the rest of the breast. One concern with areola reduction is that they can re-stretch over time. If you plan to have children in the future you may want to consider postponing surgery until you have completed your family as pregnancy and breastfeeding can influence the appearance of the breasts.

Your areolas are proportioned to your breast size but everyone has their own desires. An areola reduction is possible by making an incision around the entire circumference of the nipple. I can see that you do have some slight droop in your breast tissue but not significant enough to go through a full breast lift leaving you with scars. In my opinion, if you plan to have kids in the near future then you should wait until you are done having kids and reevaluate at that time. You must keep in mind the trade off of the scars you will have post surgery and, although not expected, the possibility of complications with breast feeding. However, if you do not plan to have kids then a circum-areolar lift would correct the slight droopiness of your breast as well as reduce your nipple to your desired size. In addition, placing an implant at the same time would give your breast a nice shape with beautiful volume.