Concentric Mastopexy Variation to Avoid Areola Stretching?

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?

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16 Doctor Answers | Asked by ashleigh4 in Australia

Doctor Answers (16)
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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.

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.

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

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.

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

3 reviews

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

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

12 reviews

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.

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