Too small too large? Ugh!

I have purchased flanges sizes 19-32 and I feel none are right. My nipples always get pulled to the opening inside the flange (which people say indicates the flange is too large) I get a red ring around my areola which makes me think some sizes 27+ are too large but when I use a smaller size I get less milk output? I am beyond frustrated I had a lactation consultant look at the issue a while back with no resolve. Any experiences with this?? I am concerned with size issue because I figured that’s why it takes almost an hour to empty but it seems no matter the size it takes about that long 😫