Dent in Areola After Small Lift Will It Correct Its Self? (photo)

Question

is it normal for areola to fold over and have a dent in areola after implant with small lift, im three weeks post op, the area that is dented and puckered is very hard, i can not contact the surgeon who did the op and i am very worried that i should be doing something.

Kenneth Hughes, MD · Answer

The dent after circumareolar lift may be due to deeper sutures or asymmetry.  The puckering usually resolves.  In addition, over time, areola tend to the lengthen in the vertical direction.

S. Larry Schlesinger, MD, FACS · Answer

Thank you for your picture.  This is very helpful.  It appears from the picture you had either a donut or a Benelli mastopexy, and it also appears from what little I can see that your plastic surgeon did an excellent job. 

	In both the Benelli and donut mastopexies with implants, there are vectors of force outward from the nipple which will widen the areola slightly, and this circumferential outward pull should correct the dent that concerns you. 

	I caution you not to do any areola massage as it may disrupt the sutures placed to give you the breast lift.  I believe time should correct your problem and I would certainly make every effort to speak with and see your plastic surgeon as I am sure he or she would be interested in helping you with this early minor problem.

Stewart Wang, MD, FACS · Answer

The indentation that's shown on the photo is most likely from a deep suture placed to control the size of the areola. It's expected to get better with time. However, you should be able to make a follow up appointment to see your plastic surgeon and discuss your concerns. In the case that the dent was caused by scar tissue retraction, it can still be revised to improve the look. With you being so early in your post operative course, I recommend that you keep follow up with your surgeon to monitor your recovery closely.

	Best Wishes,

	Stewart Wang, MD FACS, Wang Plastic Surgery

Steven H. Williams, MD · Answer

Thanks for your question -

	 

	We perform many breast lifts with and without implant placement in our San Francisco area practice.  Some irregularity around the areola in the first few weeks is not uncommon.  Soft tissue swelling and healing incisions can contribute to a lumpy bumpy look.  In the vast majority of cases this goes away by 3-6 months. 

	 

	If you have persistent irregularity typically a quick in office procedure under local can correct small issues like this.  I hope this helps.

Tom J. Pousti, MD · Answer

Thank you for your question and photo.

	Often times, small indentations / irregularities that you are experiencing do resolve with time as underlying sutures dissolve.  Since you are not able to contact the surgeon who performed your surgery and you have concerns, you may benefit from a consultation by a board certified plastic surgeon in your area.

	Best Wishes.

Darryl J. Blinski, MD · Answer

Yes the photos demonstrates an issue that needs to be addressed ASAP. Best to return again to the surgeon to discuss.

Louis DeLuca, MD · Answer

Good Morning and thank you for your photos.  The small dent around your areola is most likely a result of a suture placed deeper to maintain the proper position.  This will very likely resolve itself as the healing process progresses.

	It appears you had a Benelli (Donut) lift and it looks as though it was done very well.  Discuss your concern with your plastic surgeon so that he/she can address the problem early on.  These small dents almost always go away.  If not, they are easily correctable with a very simple procedure.

	 I think you are going to be very happy when the healing process is complete!

Remus Repta, MD · Answer

Hello,

	Thank you for the question and photo.  The areola dent is likely related to a deep suture.  If a purse-string suture was used then that is likely the cause.  I suspect it will improve with time.  Your options would be to wait longer or to go back in under local anesthesia and reset the suture.

	All the best,

	Dr Remus Repta

Steven Wallach, MD · Answer

At three weeks it is way too early to see the final result. Give it time, if anything you can always have the areola revised.

Jourdan Gottlieb, MD · Answer

Rest assured that you are not missing an opportunity to solve a problem before it becomes a bigger one. Many of these irregularities are from the suturing, and as the sutures dissolve, the indentations vanish.

	Some gentle massage on the scar is in order. When you have a chance, review the results with your surgeon.

	Thanks for your question and for the photo. Best wishes.

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