Breast Lift: Q&A
Ask a QuestionHow to Get Rid of Areolar Wrinkles?
I had a Breast lift 18 months ago (doughnut incision). The shape and feel of my breasts are okay, but the surgery left me with deep wrinkles around both areolas. When I discussed this with the surgeon he said that he should have used the T-shape technique, but reverted to doughnut further to my persistence on minimal scarring. What are my options now? Please explain those techniques with Before and After photos, if possible.
Updated May 13th: Photo added
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11 Doctor Answers |
Asked by
Chloe in Lebanon
in Lebanon
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How to smooth persistent Breast Lift wrinkles around the areolas
I completely agree with Dr. Zubowicz. The most heavily abused operation in Breast Lift surgery is the periareolar ("donut", or around the areola) Breast Lift. Unfortunately, the operation is really useful in cases of minimal breast sagging.
As you know, the normal youthful areola diameter is about 4 cm. Unfortunately, it gets stretched out with age and pregnancy. In a periareolar breast lift, a cookie cutter is used to mark a 4cm areola and then an outer circle is drawn around...
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Pleating of skin around areola after donut mastopexy
This sometimes happens after a donut mastopexy. In a donut mastopexy, a larger circumference of skin has to be closed around the smaller circumference of the areola. The larger circumference of skin has to be "pleated" to make it the same size as the circumference of the areoala. In order to avoid this, as your surgeon explained, you would have needed to add a vertical scar on the breast, which you did not want. It is possible you could have a scar revision to improve this but...
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The suture may be the cause
If your plastic surgeon used a permanent suture around your areola to keep it smaller, this can sometimes cause "pleating" like a drawstring effect. This suture can be removed if it was used and although your areola may become a little larger, the pleating should soften a lot. Best of luck.
Dr Edwards
Updated May 13th:
You almost certainly have a permanent peri-areolar suture to hold your areola to a given size. I always place the knot for my peri-areolar sutures at the 12 o'clock...
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Breast scars and areolar scars can be treated with laser
The areolar breast scars can be tightened with a laser skin resurfacing and laser treatment that can improve redness, complexion, and skin wrinkling. Check to see if this is available in Lebanon.
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Areolar wrinkling after donut lift
This result is a classic example of a donut lift used to remove too much sagging tissue, creating puckering around the nipple-areolar complex. A scar revision might slightly improve the situation but the only way to fully correct it would be to perform a secondary mastopexy using another technique. If the purse string sutures are removed or relaxed to reduce the wrinkling, sagging will ensue.
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Periareolar folds and wrinkles after Benelli lift
This is really one of the big draw backs of periareolar techniques. You can expect continued settling and improvement but also will likely have continued spreading. This is why your surgeon like most plastic and reconstructive surgeons prefer to use these techniques in cases of minimal ptosis. At some point if there is recurrent ptosis, converting to a vertical lift with a 'lollipop' scar can be helpful.
All the best,
Rian A....
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Donut mastopexy is an overused operation and correction of wrinkling requires a more formal mastopexy.
The only way to fix your scars is to elevate and advance the skin of your breasts towards the areola. This will require at least a vertical scar and possible a small extension in the inframmary crease. Donut mastopexy is seldom indicated unless the breast is "tubular".
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The Benelli (aka "Donut") Mastopexy has limited applications
This type of wrinkling is fairly common following a Benelli/circumareolar type mastopexy. Although many patients do not wish to have additional scars on their breasts, frequently it is the only way to obtain a "perky" shape. If the wrinkles that you are experiencing do not resolve over 6-12 months (and they likely may not), then your best option is to have your breast lift converted to different type that will remove more skin.
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Wrinkles around areola
Depending on the surgical technique that was used, it is possible that you may have a small amount of wrinkling around the areolar scar. This commonly resolves with time and massage. However, if after 18 months you continue to have significant wrinkling, it is possible to correct this with a number of techniques. If you only have one area that has wrinkling you may consider an injection of a small amount of corticosteroid to this region. If you have wrinkling around the entire...
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Pleating from a donut mastopexy
At 18 months out, you probably can have a scar revision without sequelae of the areola stretching. If the permanent suture is removed and a scar revision is performed, you may seem improvement.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.
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