What Causes Overstretched Areolas and How to Prevent Them when Getting Breast Implants if One Has Small Areolas?

Permanent stitches can be used to help prevent widening of the areolae after an augmentation.  However, despite this they still may stretch out.

There is a dynamic relationship between; the hard tissues of the chest, (sternum, ribcage), the soft tissue, (breasts), and the implant.  A breast augmentation augments, (enlarges), the breast tissue.  What you have on your breasts, (freckles, areola), may appear to be larger when done.  This is usually in proportion to the amount of stretch that you put on the tissue.  Sometimes the areaolas can get larger than one would expect.  Implants that are too large for the skin, subcutaneous implants, poor skin coverage, genetic skin laxity are some examples that may predispose some to large areola.  Best to have a consult with your board certified plastic surgeon.  Bring photos of what you desire.  Together you can make a plan that hopefully will avoid an outcome that you don't want.