Had donut lift, now areolas are a mess of stretched scars, what sutures will not spit for a lollipop lift revision?

I
do not recommend the lollipop lift because this creates a vertical scar, which
cannot be concealed and distorts the areola. 
I recommend a modified Benelli lift. 
This technique uses a self-absorbent suture as well as a permanent,
non-absorbent suture.  This should
prevent stretching of the scar.Best Wishes,Gary Horndeski, M.D.    

hello thank you for your question and provided information as well.. based on your question, the ideal is that in your case you would have published a photo to see the scars and see what is affected, to be able to evaluate and see if you apply for a revision. My recommendation is a consultation in person with a certified plastic surgeon. to see you and evaluate your case.

Hello,You don't provide photos, but you describe a few of the many problems associated with donut lifts performed on the wrong person: spreading scars (and usually areolas too) and spitting stitches). Be sure the new surgeon is an ABPS certified/ASAPS member surgeon who specializes in revision breast surgery. I have never had a problem with spitting stitches, even in people who thought they were prone to them. Best of luck!

Often the issue when a donut / concentric / Benelli mastopexy doesn't turn out is that the tissues were too gathered.  It is often possible to convert these lifts to lifts where the geometry of the skin is more favorable.  There are also suture choices that minimize the chance of spitting.

Hello and thank you for your question.  The
best advice you can receive is from an in-person consultation.  Based on
your description, you will benefit from a revision.  I use monocryl sutures underneath the skin, which do not tend to spit.  This decision should
be based on a detailed discussion with equal input from both you
and your surgeon.   Make sure you specifically look
at before and after pictures of real patients who have had this surgery
performed by your surgeon and evaluate their results.   The most
important aspect is to find a surgeon you are comfortable with. I recommend
that you seek consultation with a qualified board-certified plastic surgeon who
can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.  FACS
Harvard-trained plastic surgeon

Dear  betterandbetter,it is hard to tell for sure without an examination. My preferred lift is a lollipop lift when a periareolar won't do (ie greater than 2cm lift required). The lollipop technique was created by a Canadian plastic surgeon named Elizabeth Hall-Findley and treats the breast as a three dimensional structure instead of two dimensions (anchor - lift). Most importantly it does not require the horizontal component scars that the anchor-lift requires and breasts appear much more natural, lifted, and less boxy. Lastly, the lift lasts longer because the lollipop doesn't rely on the skin to hold the breast up, its actually breast tissue thats being brought together to support the breast and hence improves longevity. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Spitting can happen with any type of sutures. I personally avoid Vicryl and braided sutures, as I think they may harbor more bacteria in the braids than monofilament stitches like Monocryl, but all stitch types can extrude. The areolar spreading is not related to the spitting issue, but is more an inherent limitation of periareolar donut lifts, which have radial tension wanting to pull the areola outward (kind of like a "centrifugal" force). Accordingly, I limit periareolar lifts to situations where the nipple needs flattening and areola reduction without repositioning, or when repositioning of only 1-2 cm is required.

surgeons try to use other suture materials to see if it will avoid that  problem.  And then there are surgical techniques that bury the sutures deep rather than leaving ends close to the surface and your surgeon should make a concerted effort to do that for you next procedure.  As for the Benelli, I'm positive without a photo that your Benelli is more the problem with your periareolar scarring than the spitting sutures.  I absolutely abhor Benelli's and only use them when there is not other alternative because they flatten projection, can cause puffy areola, leave stretched out scars, and often have a palpable ring that you feel at the edge of the areola.  NONE of this is acceptable to me anymore and as more and more surgeons try it themselves, they too will eventually abandon that procedure, except in extenuating circumstances.

Spitting sutures is due to a combination of your body's own reaction to the sutures as well as the thickness, durability, and depth of the sutures. You can discuss your concerns with your plastic surgeon so he or she can review your history and make sure to use sutures that are less inflammatory and placed at a lower depth to minimize the risk of spitting sutures. I use a modified technique around the areola to avoid a vertical scar and to also avoid tension on the incision which can cause spitting sutures and widening of the scars. Hope this helps!Johnson C. Lee, MD
Board-Certified Plastic Surgeon
IG: @drjohnsonlee

I am sorry to hear of your problems with surgery.  It is common to have widened (or stretched) scars with a donut lift. I would recommend you have a traditional lift to decrease tension on your incisions, which should lead to better scarring.  Your operative report of the internal sutures used would be helpful to prevent a problem with spitting sutures in the future. Best of luck to you