Hi White Haute
The change in areolar circumference is a fairly normal outcome from breast augmentation, but the choice of a a circumareolar mastopexy at the same time has tipped the odds of asymmetry against you.
Once your breast swelling has gone (6-12 months), redoing the areolar diameter is a reasonable option - depending on the difference in sizing, it might be safer to do both at the same time. There are techniques that can be employed to make the circumference/diameter less likely to stretch out - but like all things, there can be downsides to these options as well.
Dr Gavin Sandercoe
Asymmetric areola after augmetation/ mastopexy
Larger areola can be reduced with cicumareolar mastopexy under local anaesthesia. Better to wait for 6 month befor going for revision sugery for better out come and reduce post operative streching of areola
Areola stretched after implant and a lift
There are many factors which can contribute to preventing or treating what you describe including a patients tissue quality and surgeon technique. Indeed the fact that the breast is made larger puts an element of stretch on the areola. Some surgeon use some type of permanent suture in a circle around the edges of the areola which can help prevent that from occurring, but even that cannot guarantee one, or both from stretching out again. However, in my experience re-doing it without this suture will most likely lead to the same thing happening. As far as tattooing, I couldn't recommend NOT doing this any stronger. That may look good short term, but in time, you will wish you hadn't.
Areolar consistency after mastopexy
The size of areola usually becomes larger after a circumareolar mastopexy with implant placement because of the tension the implant applies to the areola. In general, it will stabilize at a certain point. In your case, if one areola is a lot larger than the other, you may have reduction but expect that the areolar will become larger afterward. It may be difficult to achieve symmetry.
Alex Kim, MD
You likely will need revision surgery to decrease the size of the larger areola. Discuss this in detail with your plastic surgeon. It can usually be done under local anesthesia.