Permanent Suture in my breast, how to remove them? (Photo)

Question

Had surgery months ago and I don't like the permante suture, I really want to remove them also the skin around the areola does not look good.(Puckering) can both be fixed at the same time? How complicate this can be? Regards,

Gerald Minniti, MD, FACS · Answer

Hello,Although your result is very nice, as you can see the Benelli lift is not perfect.  You have minor puckering and slightly low lying nipples, but not much else. Some people are not as lucky.  It's a good lift for very small breasts that have minimal ptosis (sag), but problems arise using it on a larger or saggier breast.As you've been informed by so many doctors replying, suture removal is a surgery (minor) and will lead to areolar expansion, something you'll probably like less than your pleating. Your only good alternative is to convert your Benelli into a vertical lift.  This will eliminate the need for a permanent suture, the puckering, and improve the nipple position without expansion. It will mean the addition of a vertical incision, but it almost never is a problem visually.Best of luck!

Luke J. Curtsinger, MD · Answer

The permanent suture is very important to keep in place with a circumareolar because removing the suture can cause the areola to spread out in explosive fashion, especially if removed early in the postoperative period.  The puckering around the breast will typically settle down and improve somewhat over the first 6-12 months.   These are typical sequellae ( and potential downsides ) after a circumareolar mastopexy, and some of them have to be tolerated.

S. Larry Schlesinger, MD, FACS · Answer

Congratulations on what appears to be an excellently done Benelli (circumareolar) mastopexy with implants.  The permanent suture at the outside of your areola is there to keep the nipple areola complex or periareolar scar from spreading.  Each plastic surgeon has his or her own regiment for when the periareolar (Benelli) suture can be safely removed.If you were my patient, I would recommend you leave this suture in for a minimum of 18 months.  The reason you were able to get such a beautiful lift augmentation areola reduction all at the same time with minimal to no scarring was because of the permanent suture which you now request removal of.  This suture saved you from getting a vertical scar below your areola and allowed you to get larger implants because the breast implant pocket was not compromised.  Although this suture has become a nuisance to you, it is a very valuable stitch and should only be removed when your plastic surgeon tells you it can be removed.

Larry S. Nichter, MD, MS, FACS · Answer

It is possible to remove the permanent suture but the size of the areola would probably increase over time. You should discuss your concerns with your surgeon so that he/she can help you come up with a treatment option. Always choose a board certified surgeon!

Paul W. Papillion, MD · Answer

Hello, as stated below... puckering should continue to improve with time. The removal of the periareolar stitch is relatively easy with one or two small incisions. Locating the position of the knot is key for an easy removal. Your PS should be able to do this under local anesthesia in the office. ...and on another note...its looks like you are still relatively early in the overall process. I think things look very good overall for where your at in this process. I would be hesitant to do anything for at least a year... good luck.Dr P

Jeffrey D. Wagner, MD · Answer

You should consult with your plastic surgeon. If you have a permanent purse string suture, it is meant to stay in place to help maintain the desired areolar diameter.  Removing it may lead to a very wide areolar diameter.  The puckers will typically soften out over several months even with sutures left in.  If the suture erodes through the skin it will need to be removed by your plastic surgeon.  The other surgical maneuver to control areolar diameter is a vertical skin excision, which will leave a scar on the breast itself.

Jerome Edelstein, MD · Answer

Hello,Thank you for your question and photo. It would be possible for your Plastic Surgeon to surgically remove the Gortex sutures however this could increase the possibility of your areolas expanding or distorting over time. Puckering around the areola usually resolves within the first 6 months or so post op. Talk to your Plastic Surgeon about your concerns.All the best

Aldo Guerra, MD · Answer

Hello Carla. Yes, both can be done together. You would have to have a scar revision and have the permanent suture, which is usually Gore-Tex material removed. Speaking with your plastic surgeon is the starting point. Best wishes always, Dr. Aldo.

Nelson Castillo, MD · Answer

Thank you for your question and photographs.  Permanent suture placed around the areola is thought to control size and prevent stretching.  You didn't mention why you dislike the suture, but it certainly can be removed.  I normally advocate waiting at least six months from surgery but in your case would wait until the puckering of your skin settles before seeking removal. Hope this helps

David J. Wages, MD · Answer

Thank you for your question.  The sutures in the breast were placed by your surgeon for a reason.  Your surgeon will be the one to answer this question.  In my practice I let the patients know that if there is a permanent suture why it is there and when it can be removed if needed.  On average if a suture is causing problems it may be removed after six months.  Good luck.

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