Can a breast reduction revision (to correct excessive lower pole fullness) also make breasts smaller?

For sure, both skin and breast tissue can be removed in a revision surgery. If the nipple position is okay, then taking skin and breast as a wedge using the same vertical scar would be possible. It's likely that this would correct any lower pole heaviness and give a better shape.

A redo reduction can reposition the nipple, remove tissue, and remove skin.  Your original surgeon is the best person for determining blood supply to the nipple.

Breasts
can undergo repeat reduction to decrease the volume.  Another alternative to consider is The
Bellesoma Method.  This will reduce and
reshape your breast tissue creating upper pole fullness without implants,
elevate them higher on the chest wall and more medial to increase your
cleavage.  The weight of breast is
transferred to the underlying pectoralis major muscle resulting in pain relief
and long term stability.  Vertical scars
are avoided, nipple sensation and the ability to breast feed are maintained, if
not injure during your previous surgery. 
  Best Wishes,Gary Horndeski, M.D.

I have taken care of women who years after their first breast reduction developed what we call "pseudoptosis."  This is when the breast tissue sags into the lower portion of the breast skin envelope, and the nippple/areola often will appear to high as well. During a breast re-reduction, we can remove that heavy tissue and excess skin in the lower pole of the breast. Definitely meet with a board certified plastic surgeon to be evaluated. 

Sorry to read you were unhappy with the results of your recent breast reduction surgery.  Without before and after photos its difficult to give your advice on your options. You should discuss further with your surgeon your concerns and options for revisional surgery.

Yes, a re-do breast reduction can/will have the benefits of reducing your breast volume/size as well as improving the overall shape and position of your breasts.
Best of luck

Yes, it is certainly possible to further decrease breast size by removing lower breast pole skin/tissue. My best advice: communicate your concern and goals carefully with your plastic surgeon. Work together you will come up with a good plan to improve your outcome. Best wishes.

Thank you for your question. Yes, this procedure can be modified to your needs to improve the size and shape of your breast. You should consult a plastic surgeon who is an expert in this field.

Hello and thank you for your question .   Yes, you are basically having a reduction and your PS would use the same scars from previous mastopexy.  

Hi there Luda and thanks for posting,You can most certainly have more breast tissue removed from the lower pole of your breast.Not sure what technique you had initially, but the description you provided is common with the vertical technique.Correction is quite simple, but would definitely require a scar in your inframammary fold.In short you need to have the distance from you fold to your areola shortened along with breast tissue. A skin only reduction would have a hight likelihood of recurrence.Best wishesRichard