I had a benelli breast lift 5 years ago and had open wounds all over for mos. which left horrific scarring. I am only finding out now that the gortex stitches should have been removed. Vicryl sutures were also used by the areola which I did have some spitting issues. I also discovered later on that I am allergic to surgical tape. Finally, I have the courage to go for a T mastopexy. I am petrified about infections/spitting sutures reoccuring. What sutures are less prone to spitting/infections.
Benelli Breast Lift Open Wounds?
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Doctor Answers 13
Benelli Lift open wounds
I am sorry that you have had a bad experience with your previous breast lift. My suspicion is that your issues have nothing to do with the sutures, but rather with the type of lift you underwent. The Benelli lift is an appropriate procedure for minor lifts or for more extensive lifts in cases of tubular breast deformity. However, when this operation is over used in an attempt to correct conventional sagging, excessive tension results in the suture line. In this situation, regardless of what suture is used, the incision will break down exposing the underlying sutures and result in bad scarring. I have found that patients have undergone this procedure too often when they should have undergone a vertical lift.
I understand the reluctance of some patients to have visible incisions on their breasts, particularly a vertical one that extends from the areola down to the inframammary fold. In response, patients will undergo the Benelli type lift where there is only an incision around the areola in order to avoid this vertical incision. The result often is an inadequately lifted breast with a bad areola scar. However, If one was to compare the quality and visibility of the three conventional incisions used to perform a breast lift (areola, vertical, and horizontal), it is ususally the vertical component that heals the best and often is extremely difficult to see.
Therefore, it appears to me that you should never have had the Benelli lift, and that your current issues can be solved by undergoing a vertical lift.
Ary Krau MD FACS
Benelli Breast Lift Open Wound
Sorry to hear about the wound healing issues you had. The Gore-tex suture that was used was presumably a purse-string suture around the areola and they are usually meant to be permanent. Once these become exposed or get infected, they need to be removed. The other sutures were probably not the cause of your problem, and it would be unlikely that this would occur with a vertical lift. With a vertical lift it Gore-tex is usually not used. The most common cause for scar problems is excessive tension, which hopefully you surgeon will avoid with your next procedure. Good luck.
Monocryl Sutures for Vertical Lift
Monocryl is a monofilament with low tissue reactivity. There will not be a need for the permanent suture this time. You should find a board certified plastic surgeon with ELITE credentials who performs hundreds of breast lifts each year. Kenneth Hughes, MD Los Angeles, CA
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Sutures may be pushed (or "spit") out if the are very superficial (close to the skin) or do not dissolve. Gortex sutures are permanent and meant to be left in place. Vicryl suture has a slightly higher spitting profile. Monocryl or PDS suture are other options. Lastly, unlike in the Benelli lift, Gortex suture is not used in T or lollipop lifts.
Benelli lift and scarring/suture reaction
Dr. DiFrancesco has given some great points. I would add that by definition, the Donut pexy...Benelli...has the inherent tendency to put a lot of strain on the scar around the areola because there are forces acting in all directions outward from the areola. For this reason, the areolas have a tendency to spread. This sometimes gives a very unattractive enlargement of the areolas.
Many approaches and sutures are used to try to prevent this spreading. By doing the vertical incision, the areolas are 'locked" at the 6 oclock position and then there is less tendency to have the areola spread.
I think the best thing to do is to present to your plastic surgeon and get some ideas. I would guess you will need the scars removed and revised along with decreasing the size of the areolas (if needed) but with you now having the openess to a vertical scar, then there can be many different sutures that can be discussed to get less reaction and have a more attractive result. Notice too that the breasts can be "flattened" by the donut pexy. The vertical excision of tissue can help restore the more teardrop form of the breasts.
Sutures that limit spitting in breast lift
Gortex suture is a permanent suture, and infection can be managed conservatively first, with antibiotic, but if that doesn't do the trick the suture is removed. Vicryl sutures absorb over time, but are "braided" and do have propensity to attract bacteria as well. Non-braided "monofilament" suture is less inflammatory than braided. Monocryl will absorb faster than PDS, so is less inflammatory than PDS. Skin glue like Dermabond also may help in sealing the wound and protecting it better during healing. Talk to your plastic surgeon about suture choices he/she will make to optimize your healing outcome. Good luck!
Gortex sutures are meant to be permanent sutures and are usually placed around the areola in the benelli breast lift. A vertical or T mastopexy does not use the Gortex suture.
Vicryl sutures are know to "spit" when placed close to the skin. In the vertical or T mastopexy the vicryl suture is placed deep. If you are still concerned another type of suture such as PDS can be used during the procedure.
Permanent sutures are more likley to spit because they do not dissolve. For the most part when a vertical lift is performed, permanent sutures are not used.
Benelli Breast Lift Open Wounds?
Gortex sutures are meant to be permanent sutures; that is, left in place around the nipple areolar complex (purse string). Vicryl sutures do not usually spit unless placed too close to the epidermis and the enzyme level is not strong enough to dissolve the sutures. Deep dermal Vicryl sutures rarely spit when placed correctly. Sometimes shear forces cause problems with tape and the skin but these areas usually heal rapidly.
Problems with Benelli Lift
What happened to you is not uncommon and why I abandoned that procedure years ago. A vertical or "lollipop" lift will result in better more predictable arealor shape and thinner scars. I would use PDS and Monocryl for you, they are nonreactive and well tolerated. Make sure you pick a surgeon with extensive experience in revisional breast surgery. Ask lots of questions and look at the surgeon's post-op pictures. Good Luck!
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.