Permanent suture in nipple or something else? Help!

Question

I am 2 years post periareolar mastopexy and have an odd question that I’m not even sure how to describe. I have the typical scar around the areola, but can feel what seems to be a perfect open circle about the size of a penny around each base of my actual nipple. When my nipples are soft the tissue kind of bulges from the circular ring (right around the diameter of the nipple, not the areola). Is this a permanent suture or something else ? My procedure notes have given me no answers.

Gary Lawton, MD, FACS · Answer

If you had a periareolar lift then you have a blocking stitch which is permanent that keeps the radial forces from spreading the nipple.  You are feeling the knot.

Daniel Barrett, MD · Answer

Dear JRue19,I understand your concern. However, without a proper assessment it would be difficult to determine what is wrong. It is best that you visit your plastic surgeon for further assessment. Only after thorough examination you can get proper recommendations and advice.Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Himansu Shah, MD · Answer

Thank you for the question. It is difficult to answer your question without examining you however from reviewing your description it most likely is a permanent suture. It is very important especially in an circumareolar mastopexy to prevent it from stretching. It is best to discuss with your board certified plastic surgeon. Good luck.

Robert M. Tornambe, MD · Answer

JRue19.   It sounds like you’re describing a permanent suture at his place during this type of procedure to prevent the Ariola from spreading or becoming too large. However, it is best to follow up with you Plasticsurgery for a full evaluation. Good luck.

Nelson Castillo, MD · Answer

Thank you for sharing your excellent question.  When attempts at limiting areolar spread are performed a permanent suture like Gore-Tex can be used.  Unfortunately in some thin patients this suture can be felt readily.  If this suture causes you issues, you can have it removed by your physician.  Hope this helps.

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