Breast Lift Q&A

84%

WORTH IT RATING

219 Reviews

Ask a Question

View Before and Afters

Average Breast Lift Cost: $7,800

Learn about Breast Lift

1,232 people and 670 doctors are talking about Breast Lift

Get Free Email Updates

Concentric Mastopexy Variation to Avoid Areola Stretching?

asked 2 years ago by ashleigh4 in Australia
Latest answer by Tom J. Pousti, MD
Question viewed 1,159 times
Tags: areola

I am having 2nd areola reduction when i get smaller implants. My first areola reduction using purse string technique was horrible; permanent sutures and the knot could be seen and felt and one areola was very puffy. After this i got bigger implants and another areola reduction with the permanent sutures taken out and not replaced. Needless to say while happy with the apearance they have stretched to bigger than before.

I need a technique that will eliminate these problems, i found one i never heard of using mesh underneath areola for support. Called Concentric mastopexy variation. Has anyone heard of this? Would you recommend it to help my problem?

16 answers to Concentric Mastopexy Variation to Avoid Areola Stretching?

Problems with Circumareolar Breast Lifting?

Thank you for the question. You have described the downsides of using permanent as well as the downsides of using absorbable sutures. The best solution I believe does not involve the use of mesh. You may need the planned change to a vertical mastopexy to relieve tension around the areola area. This can only be determined upon the direct examination. I hope this helps.

Tom J. Pousti, MD
San Diego Plastic Surgeon

Problems with peri-areolar mastopexy

Hi there- It sounds like you may need to consider a different technique, a different surgeon, or both. In my experience, the only times I have seen problems with areolar stretching were when the patient really needed a different type of lift procedure, but had a peri-areolar lift because they wanted the smaller scar. I always ask my patients (when I think they would be better off with a different technique)- "If your breasts look funny but you have the scar you wanted, will you be... more

Armando Soto, MD
Orlando Plastic Surgeon

www.DrArmandoSoto.com

Periareolar or Circumareolar Mastopexy & Breast Augmentation

This operation can be done without having areolar enlargement if the right permanent suture is used and placed in the proper position. An interlocking purse-string suture and reduction to small implant should give you the result you desire. Another option would be to convert to a vertical patterned mastopexy.

Ankit Desai, MD
Jacksonville Plastic Surgeon

Cutting away skin only won't work, that's for sure

For any plastic surgeon who does a lot of breast surgery, they will tell you that taking up the excess skin by making a tight suture around the areola only just won't work for huge areolas. The surgeon has to do SOMETHING to support the breast, whether it be mesh, lifting the breast tissue itself with an internal mastopexy, or the like. That's why you will hear a lot of surgeons say that you should have a vertical scar, because through this method they reduce skin tension on the areolar... more

Lisa B. Cassileth, MD
Beverly Hills Plastic Surgeon

Areolar stretching after augmentation mastopexy

Unfortunately, the biggest problem we have with augmentation mastopexy is areolar stretching. The only solution is a permanent stitch but I agree the stitch may be able to be felt if not buried deep enough. The breast lift with mesh you are referring to is a technique develped by a Brazilian plastic surgeon named Goes. He uses this mesh to envelope the breast tissue, below the skin, then support the tissue for lifting and prevent areolar stretching. Unfortunately, the mesh he uses isn't... more

Christopher L. Hess, MD
Fairfax Plastic Surgeon

www.hessplasticsurgery.com

Periareola reduction

A periareola reduction cann only be performed in the right individual. If your areola are very large and you need a lot of skin excised to acoomodate for laxity, then you may have been better off with a formal lift. I use a gortex type suture which is very soft and I can not remember a single patient complaining about the palpability of it.

Steven Wallach, MD
Manhattan Plastic Surgeon

Breast lift around areola is a good operation with a good surgeon.

Hi. As with almost everything in plastic surgery, what matters is the skill and good eye of the surgeon, and not the name of the operation. Periareolar breast lift with areolar reduction and breast implants is a great operation if done properly.

George J. Beraka, MD
Manhattan Plastic Surgeon

Purse String Areolar Reductions or breast lifts have these problems frequently

The smaller implants will help take the tension off, but the purse string technique is known to have all of the problems that you mentioned. The best solution would be to add the vertical scar. This will redistribute the excess skin instead of purse stringing it together.

Daniel P. Markmann, MD
Baltimore Plastic Surgeon

Concentric Mastopexy+Areola Reduction+Large Implants= Lousy Combination

Great question. Your dilemma affects hundreds of women who successfully pressured their plastic surgeons to do a periareolar mastopexy when a Vertical scar mastopexy would have been the answer. Think about it for a second - WHY would you require a permanent periareolar suture after an areolar reduction if you areola was really that large? Was it because it was either over reduced and / or stressed with an implant whose foreward pressure put constant tension on the repair ("knot could... more

Peter A. Aldea, MD
Memphis Plastic Surgeon

Concentric mastopexy variation to avoid areola stretching

Not heard, seen, or done the mesh mastopexy of the areolars. I would be very careful with this technique. Sounds too good to be true. From MIAMI

Darryl J. Blinski, MD
Miami Plastic Surgeon

Mesh for maintaining breast shape, not areola size

I have heard of the mesh technique. It is based off the Goes technique. This is really to help preserve breast shape and not control areola size. I have had good results by controlling the areola with the interlocking GORTEX suture. In my hands it has worked well. Unfortunately, all tissue relaxes a bit but this technique minimizes total loss of control of the areola size. Hope this helps.

Earl Stephenson Jr., MD, DDS
Atlanta Plastic Surgeon

Areolar stretching

I believe that your areolas stretched with the second procedure because the larger implants created more tension on the periareolar closure, and there was no purse string suture placed to stabilize the diameter of the closure. You should have better luck with the smaller implants and a new periareolar purse string suture. The mesh technique your are referring to is popular in Brazil, but the mesh is used as a sling tho support the breast lift (like an internal bra), not the areola. One... more

Bruce Genter, MD
Abington Plastic Surgeon

Periareolar breast lift is prone to areolar stretching

Breast lift or mastopexy by the around the nipple or periareolar technique is prone to stretch the nipple areola with a recurrence of the breast droop. The permanent surture, also called a round block suture is meant to reduce the stretch and recurrence and provide a more lasting lift. It is uncommon for the suture to be visible or uncomfortable. There is a very effective alternative, and that is conversion to a vertical breast lift pattern. The tension is removed from the nipple and the... more

Peter E. Johnson, MD
Chicago Plastic Surgeon

Mesh technique designed to help maintain breast shape and lift

You have just described the most common problems associated with large implants and permanent purse string sutures. It is good to hear that you are going to smaller implants. This will remove some of the weight that is contributing to your areolae stretching and enable you to have an areolar reduction. The concentric mastopexy using mesh is a technique designed and described to maintain breast shape and lift, not to avoid areolar widening per se. So, to recommend it for such would not be... more

Kenneth R. Francis, MD
Manhattan Plastic Surgeon

Mesh in Australia

I don't have much experience with mesh in the breast as it is not used in the USA. It almost sounds to me like you are trying to get too much out of a periareolar mastopexy. At this point have undergone at least 2 surgeries you might consider a vertical mastopexy which will do several things. First of all it will take stress off the pursestring suture and leave you with a much better scar and second, it will probably give you a much better lift when going to smaller implants. I would see... more

Steven Schuster, MD
Boca Raton Plastic Surgeon

www.schusterplasticsurgery.com

Periareola areolar reduction

All periareolar reduction will eventually stretch especially with the increased volume and pressure of an underlying implant. The only way to reliably reduce the diameter of the areola is to do add a vertical scar component. It is a simple matter of physics, not magic.