Scarring is terrible - is this a normal level of scarring after my procedure & revision? I've never suffered with keloid or excessive scarring before Unhappy with size (too small) & shape of breasts after surgery I don't see a significant change My ps used vicryl dissolvable stitches on both procedures healing took over 3 month
Nipple Lift & Implants to Improve Asymmetry and Reduce Areola Gone Wrong? (photo)
Doctor Answers (6)
Consider requesting your surgeon culture your wounds. You most likely have stitch abscess from a commonly utilized but, relativily outdated suture called Vicryl. This a woven braided suture that has a higher incidence of post operative stitch abscess when exposed. They typically spit out or have to be removed. It is often utilized because, it is cheeper than monofilament sutures like PDS. Best,
Gary R Culbertson, MD, FACS
Lift and implants
It looks like you did not respond well to the absorbable sutures. You may need a revision using a different technique.
Nipple Lift & Implants to Improve Asymmetry and Reduce Areola
It seems that both times you have reacted unfavorably to the dissolving suture material that was used, and that the areola has widened. It looks like you have had a periareolar (donut) lift. Although there are times that this sort of lift gives a satisfactory result, this is not one of those times.
If the size is too small, you would need to consider larger implants.
In terms of the lift, I would suggest converting this to a vertical lift. This alone gives better control of areolar size, but I would also suggest a gore-tex purse-string suture around the areola. I would suggest avoiding as much as possible any buried internal sutures, and use sutures that will be removed. The current scars are worse than average, probably related to the reaction to the vicryl.
Thanks for your question, and for the useful photos. All the best.
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Tension and Vicryl sutures
Thank you for the question and the photos. It appears like you are having some delayed healing around the areola. This is likely the result of excessive tension and possibly also Vicryl sutures. I would let everything heal at this time. The good news is that revision can help. During your revision a permanent gortex suture can be used in a purse-string type fashion to repair the areola and the scarring. The link below is from one of my patients.
All the best,
Dr Remus Repta
Nipple Lift & Implants to Improve Asymmetry and Reduce Areola Gone Wrong?
This question very difficult to address. Yes you have a vicryl allergy and should NEVER use it again. But the "overall" result is very good comparing the before photo to the afters. Scarring is the separate issue now. Allow a year of maturation of the scars before considering further revisions.
Revision and Still Poor Scarring
This question is difficult to answer as this may be the best you can hope to heal after breast surgery. However, some plastic surgeons may suggest that use of an alternative suture may produce a better result.
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.