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Am I Doing the Right Thing with Periareolar Scar Revision? (photo)

asked 8 months ago by boobiesonmymind in Panama City, FL
Latest answer by David Bogue, MD
Question viewed 810 times
Tags: 5 years post-op, areola incision, options

I have my in office procedure scheduled on Monday! I am very nervous but trust my surgeon who said he can make a lots of improvement w/ my scars around areolas. My scars are from benelli lift + augm in 2004 performed by another surgeon. I am content for now with the way my breast look after explant ( 8 months post explant of silicone 390cc). My priority is to fix these scars which i have been bothered by for a long time. Any tips on sutures etc???? Thanks

17 answers to Am I Doing the Right Thing with Periareolar Scar Revision? (photo)

+1

Periareolar scar revision.

Revision of the periareolar scars is a common procedure. These scars are often widened and unattractive when they are performed at the time of a breast augmentation (augmentation mastopexy). This is a normal response of the scars to the increase in tension from the augmentation. At this point, particularly following your explant, these scars are likely to heal with much more predictability.
David Bogue, MD

Boca Raton Plastic Surgeon
+1

Periareolar Breast Scar Revision

There are three things that cause scars like the ones you have. They are wound tension, how the incision was closed and your skin/dermis. You no longer have the tension you had when the Benelli lift was done, so that should improve the result. When a scar is revised, the suture should be strong enough to resist what tension is present and last at least six months until the scar is strong enough not to stretch any further once the suture is no longer supporting the wound. For this, I use a... more
Robert T. Buchanan, MD

Highlands Plastic Surgeon
+1

Fixing a periareolar scar

The problem is that when the first surgery was done, a large circle of skin was sewn down to the areola and now by removing the scar, the outer circle is effectively bigger than the first one was. So why would it heal any better in the long term? Maybe if a permanent suture wasn't used the first time. But if you really want the best areolar scar, a full mastopexy will allow the areola to be put into a circle of exactly a 1:1 size relationship and the extra loose... more
Richard P. Rand, MD, FACS

Seattle Plastic Surgeon
+1

Periareolar scar revision should improve your scars, but...

Hi there- I do think that meticulous technique and a careful postoperative scar protocol will give you a nice improvement in the appearance of your scars... On the other hand, I think that overall, the improvement in both these scars and the shape of your breasts would be greater with a vertical breast lift.
Armando Soto, MD

Orlando Plastic Surgeon
+1

Areolar scar revision bilaterally.

You appear to still have quite a bit of breast tissue and may like the results with a limited scar revision for the areolae. this revision should give you a more balanced areolar skin scar than you currently have. If done properly this would be a better result. Good luck to you.
Francis (Frank) William Rieger, MD

Tampa Plastic Surgeon
+1

Scar revision around areolas

I believe you will see much improvement if revision is well done. I prefer using a permanent purse string stitch to minimize re-stretching of scar. It prolongs the lift and is esthetically more pleasing in the long run. Best wishes, Dr. H
Gary M. Horndeski, MD

Houston Plastic Surgeon
+1

Periareolar scar revision will work well if tension is reduced

One of the most significant problems with widening and thickening of the periareolar scars is tension across the incision, leading to irritation of the wound and thickening of the resultant scar. The most important element of decreasing the scar response is to decrease tension across the incision and weight of the breast. Structural changes supporting the breast gland are important, and in-office treatments simply focused on the skin are seldom successfull. Secondarily, direct... more
Mario Diana, MD

San Antonio Plastic Surgeon
+1

Revison of the Bennelli scar

The Bennelli lift, or around the nipple scar is prone to spread with recurring breast ptosis, and at worst have a 'star burst' pattern around the nipple. Now that the large implants are removed though, there is a better chance that a revision of the scar will reduce the spread and irregular pattern. The revision is a good idea if well done. Best of luck, peterejohnsonmd.com
Peter E. Johnson, MD

Chicago Plastic Surgeon
+1

Difficulties in scar revision after periareolar breast liftslifts

No matter how good the technique or meticulous the closure the surgical realities are stacked against a PERMANENT improvement. The removal of the outer spread scar will create a much larger circumferential defect. When this is pulled inward to join the smaller circumference of the areola something has got to give. either the areola spreads unestheticaly or the scar spreads as it did in your situation.
Barry H. Dolich, MD

Bronx Plastic Surgeon
+1

Great chance for improvement

Your original scars healed this way due to tension perhaps from the size of the implants that were put in at the same time. But they also may have healed from your own gnentic tendency to heal your scars this way. Having them re-done now makes sense and they just might heal completley differently without the tension you had before. Ask your surgeon about ways to reduce scarring from post surgical gels and ointments as well. I hope all goes well for you. more
Phillip C. Haeck, MD

Seattle Plastic Surgeon
+1

Periareola scar revision

What do you mean by "fixed?" It sounds like an elementary question but it is important. Do you mean the pigmentation? The atrophy skin? The size of the areoa? Scars have different characteristics that a surgeon can attempt to change such as pigmenation, degree of firmness, color, height of scar. etc. Also, how long do you want the effect to last? A Benelli lift takes a large circle and sutures it to a smaller one. Over time, because of the degree of tension on the scar and soft... more
Robin T.W. Yuan, MD

Beverly Hills Plastic Surgeon
+1

Scars around areolar, can they be fixed

Having seen this type of scrring in several patients, I will unfortunately voice an opposing opinion. Although a scar revision will improve the scarring I also think the scar will again widen. I do feel you can try the periareolar scar revision but I also feel you will get a far better result with a vertical mastopexy which would decrease the difference between the outer circle and the areolar circle. The lower pole excess could be used to auto augment the breast and... more
Steven Schuster, MD

Boca Raton Plastic Surgeon
+1

Periareolar Scar Revision

I think you are making a good choice and have a very good chance at a lot of improvement. The original scar problems may have been because the implants put a lot of tension on the original wound closure. Now that the implants are out, tension should not be an issue. You will have some temporary"bunching" around the wound edge because you are closing a larger circle around a smaller circle, which causes a "purse string" effect. As for suture, it's best for you to not... more
Joseph Fata, M.D.

Indianapolis Plastic Surgeon
+1

AREAOLAR SCAR REVISION

Thanks for the photos. On closeup your scars are thick, wide and discolored. Revision will significantly improve the scars maybe around 50% but this may need to be done again in 6-12 months. As I am sure your surgeon explained to you, when you close a larger outer circular scar to a smaller inner circular sca,r there will be some bunching and this may take 6 months or longer to resolve. Slicone scar treatment will be beneficial post revision. Good luck. more
Todd B. Koch, MD

Buffalo Plastic Surgeon
+1

Scar revision of benelli and cold-subfascial lift

I would recommend a change of planes and revision with structural support for your aereolas. Your implants are low and will continue to descend as they appear to be subpectoral. a change of planes to subfascial placement and scar revision with four separate transareolar support sutures and an outside supportive pursestring should give you a nice result. All the best, Rian A. Maercks M.D.
Rian Maercks, MD

Miami Plastic Surgeon
+1

Likely improvement

This is a challenging problem and not at all uncommon. The problem arises when two contradictory actions take place - namely removal of skin (thats the lift) and stretching of skin (thats the augmentation). Tension is always the enemy of good scars. By revising the scars without the tension that accompanied the original surgery, your scars should be better. Good luck. Dr Frank
Robert Frank, MD

Munster Plastic Surgeon
+1

Nipple scar revision

Judging onle from your photo, I think you stand a good chance to see significant improvment from a scar revision. This is certainly a procedure that can be done as an office procedure. Regarding suture choices, your surgeon will use the suture he or she feels will give you the best result. Their training and experience will guide them in which suture and technique to use. Best wishes!
William H. Gorman, MD

Austin Plastic Surgeon

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