My areola incision is still open. Is that normal? Almost 4 weeks. (Photo)

Way too much tension, as evidence by your early spreading nipple. It looks like you've got some fat necrosis (death) along the line of closure. You will need to be followed up closely to ensure the implant does not get exposed with this.

Your skin might be having a reaction to the suture. It does not look like an infection, but still check with your doctor. A reaction to the suture is not uncommon and will heal normally after a year.