2nd surgery.. LIPO only?

[jason_w]

delete.

[giggsy]

maybe its scar tissue?

[Dr. Elliot Jacobs]

What you seem to be describing is an animation deformity -- a crater that appears when you flex or when the arms are raised over the head.  IMHO, the only reason for a crater is excess removal of tissue directly under the nipple so that there is no support and it caves in with certain maneuvers.  Oftentimes, when the arms are at the sides (which is 98% of the time), it may appear normal.

Treatment with additional lipo in surrounding areas doesn't provide added support for the areola -- but it may lessen the appearance of the crater because there would be a smaller disparity between the surrounding skin and the depth of the crater.
In cases similar to yours, I usually perform fat flap reconstruction if there is adequate surrounding tissue to donate for the fat flaps.

Good luck!

Dr Jacobs