Removal and replacement of smaller implants with mastopexy? (Photo)

If you're having smaller implants placed the surgeon may be able to excise all of the areola along the scar line. If your surgeon isn't able to excise all areola along the scar line during your surgery, this could probably be fixed later as a minor procedure several months after your lift once the tissues have healed and relaxed a bit.

Your surgeon should be able to avoid bringing pigmented areolar skin to the vertical incision if planned properly. I don’t see any problem avoiding that in your case. If it does occur it’s very simple to revise later under local anesthesia

If you go smaller, more skin can be removed and the excess areolar skin can also be removed. Your surgeon can discuss this with you.

Sometimes it’s difficult to remove all the areola skin and still close. Skin incisions without increasing risk for complications.
If you leave the areola, at its size, then you won’t need to worry about the problem.
Sometimes after patients are healed up a little more skin, can be removed on the vertical scar removing all or most of the residual areola skin. That can often be done under local anesthesia in the office.
Some of the decision making may be slightly subjective, and the balance is generally between aesthetic outcome and surgical safety.
I’m guessing your plastic surgeon explained why the outcome is likely to be the way it is.
You can always have more consultation and get a second opinion.
There are a lot of things to take the consideration, and there’s no a yes, or no answer to your question. A more aggressive approach may be able to remove all the areola skin, but this also increases complication rates.
I suggest putting faith in your surgeon who has your best well at hand. This includes a healthy balance between aesthetic outcomes and surgical safety.
Best,
Mats Hagstrom, MD