I have permanent sutures inside my breast used to reduce my areolas. Is it possible to remove them?

Question

I had tuberous breasts which were corrected 8 years ago. I recently found out that I have permanent sutures inside my breasts used to reduce my areolas (I guess Benelli). I feel pain in my nipples sometimes (Restricted blood circulation?). Before surgery, I never had such symptoms. Post 8 years, is it still possible to remove them?

Zoran Potparic, MD · Answer

Permanent sutures used for Benelli lift or areola reduction (they are made of Gortex) would integrate with tissue and it may be difficult to remove them without making multiple small incisions around areola. There is a possibility that scar around areola would stretch after removal of sutures? If you do note physically feel them, I would advise against removal. It is unlikely that pain you experience is related to suture only. In person consultation with a board certified plastic surgeon expert in breast surgery is recommended. Good luck.

Richard H. Tholen, MD, FACS · Answer

Short answer: Yes, but it will almost certainly NOT change your pain, and your areolas may stretch (sometimes significantly, which is why permanent sutures are used in the first place). 
This not a "restriction of circulation" issue, as everything is healed and circulation is intact if tissues are alive. I know it sort of looks like a tourniquet, but the nipple would be dead if the restriction was severe enough to be an issue. Nipple circulation is not just through the skin, but also from deeper tissues, which is why you have perfectly adequate and sufficient blood supply.
Pain is due to nerve irritation/damage during the surgery process. Healing can improve sensation and decrease soreness over time, but may not resolve it completely. After 8 years, your healing is complete and your sensory issue (pain) is unlikely to change, even with suture removal. 
However, suture removal will not cause any issues other than areola widening and perhaps a return of some degree of "puffiness," so you can talk to your plastic surgeon, who will likely inform you similarly (and likely dissuade you) since pain will not improve as scars will not be "unscarred." You can get new scars , with or without a permanent purse-string suture,, but then you have nerve irritation/healing all over again--maybe better, maybe worse, but probably not worth the effort. Your choice. Best wishes! Dr. Tholen

Gary M. Horndeski, MD · Answer

If the sutures are peri-areola, you will be able to palpate them by inserting your finger inside the areola and pushing outward.  If they are not peri-areola, but are deep sutures, they will be very difficult to remove.Best Wishes,Gary Horndeski, M.D.

Roger Tsai, MD · Answer

Great question! Yes the suture could potentially be removed; however, it probably will not alieviate the nipple issues you are having. If there was any blood circulation issues, you would have noticed within days of there surgery. After 8 years, there are new blood vessels that have grown in. You will need to speak to your surgeon to go over the risks and benefits of removing the suture.Best of luck and hope this information helps!

- Dr. Roger Tsai @DrRogerTsai
Board Certified Plastic Surgeon

- Dr. Roger Tsai  @DrRogerTsai
Board Certified Plastic Surgeon

Ronald J. Edelson, MD · Answer

It would be quite simple to remove the purse string sutures of a benelli lift.  It may alleviate the duscomfot you have but there is no way of knowing ahead of time.  Of course your areolae will stretch out a bit also.

Daniel Barrett, MD · Answer

Dear tubii,
It is hard to tell for sure without an examination and surgery notes. If you have permanent suture, then it can probably be removed under local anesthesia. If you are considering removal, 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

Curtis Wong, MD · Answer

after a Benellli lift can be done and if your surgeons knows where the knot was placed, it makes it relatively easy.  Otherwise its removed piecemeal and takes more incisions to do that.  Its hoped the skin has stretched around the areola so it will not pull back and away and end up stretching out the scar around the areola but this happens when that suture fails early in the recovery.  Understand the suture is not likely the cause of your symptoms and that removal may not result in resolution.

Stephen M. Davis, MD, FACS · Answer

Thanks for writing,Having been working for 30 plus years, to date, I am yet to see anyone complain of nipple pain associated with these sutures. These sutures are place in the skin / deep dermis around the areola and simply pulled like a purse string to shrink and control areolar size. The nipple is not involved and neither are the deep tissues behind the nipple or breast. The blood supply to the nipple comes from below not typically from the sides. Nipple sensation comes from the lateral chest wall via the back, there could be and probably is scar there that may be affect the nerve.I did have one patient years ago who felt here areolas were too small and wished the purse strings removed.  After explaining size, dimensions, areolar breast aesthetic relationships she still wish  them to be removed, which I did for her. Within a periods of weeks to months her areolas splayed out more than twice the size, she called them dinner plates, she then requested replacement of the sutures for the aesthetic improvement. I hope this helpsStephen M. Davis, MD, FACS
Certified: American Board of Plastic Surgery
Member: American Society for Aesthetic Plastic Surgery
Member: American Society of Plastic Surgeons
Member: RealSelf Hall of Fame
VERIFIED: Plastic Surgeon

Robert L. Kraft, MD, FACS · Answer

At this point, the sutures could not be found in most cases, let alone removed. There can be many reasons for breast pain which could warrant investigation but restricted blood flow would not be one of them.  See a breast specialist for a thorough examination.

David Finkle, MD · Answer

Looking for sutures that were placed 8 years ago would literally be like looking for a needle in a haystack.  Any compromise of circulation from the surgery and sutures would have occured within a week of the procedure, not 8 years later.The discomfort/pain you are experiencing is probably related to the procedure, but more from scar tissue than anything else.  So, even if you could find and remove the sutures, the discomfort may not change.Good Luck!

I have permanent sutures inside my breast used to reduce my areolas. Is it possible to remove them?

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