Wrinkling or puckering of the nipple/areola area after a breast lift can occur for several reasons, and it is often related to how the skin heals and responds to changes in tension, especially without the added volume from implants. Here's a breakdown of potential causes and solutions: Potential Causes of Nipple Wrinkling Post-Breast Lift 1. Tissue Tension and Skin Redundancy: o During a lift, skin is tightened and repositioned, and without implants, there can be a lack of fullness, particularly in the upper pole, leading to some puckering or wrinkling. 2. Suture Technique: o If the wrinkling is localized near the incision line, it could be related to the sutures. In some cases, internal sutures cause tethering, leading to uneven healing or slight skin bunching. 3. Natural Healing Process: o It may take 6-12 months for all swelling to subside and tissues to settle. However, since you’re at the 6-month mark, any remaining wrinkles may not completely smooth out without intervention. 4. Skin Elasticity Issues: o The skin on the areola is delicate, and in some individuals, it may not smooth out completely, especially if there is minimal upper pole support. Potential Solutions for Persistent Nipple Wrinkling 1. Massage Therapy: o Regular scar massage or moisturizing massage (with silicone gel, Vitamin E oil, or cocoa butter) can help relax the tissue and encourage smoother skin. 2. Laser Resurfacing or Microneedling: o Fractional laser treatments or microneedling can help improve skin texture by stimulating collagen production, which may reduce wrinkles and smooth out the area. 3. Fat Grafting (Fat Transfer): o If the wrinkling is due to a lack of tissue volume, fat transfer can provide subtle upper pole fullness and smooth out the area around the nipple. 4. Non-surgical Skin Tightening (RF or Ultrasound): o Treatments like radiofrequency (RF) or ultrasound-based therapies (e.g., Morpheus8) can help tighten loose tissue and improve overall skin texture. • Consult your surgeon: Since you mentioned one side may be a result of suture placement, it’s a good idea to schedule a follow-up. Your plastic surgeon can assess whether a minor revision would be beneficial. • Monitor changes: It’s still possible for some improvement over the next 6 months as tissues continue to soften and settle, though surgical or non-surgical interventions may be needed if the wrinkling persists. If the wrinkling bothers you aesthetically, your plastic surgeon can tailor the most appropriate solution based on your anatomy and desired outcome.