Internal Stitches for Benelli Lift?

Puffiness of the areola after a Benelli (or donut) breast lift is due to leaving the areolar skin too loose compared to the size of the final circle. This is easily corrected my removing more of the areolar skin.

Without seeing photos , it is difficult to make any definite recommendations but it sounds like you would benefit from a permanent suture to prevent the areola from widening again. I prefer Gore-Tex sutures rather than other permanent materials because it is very soft.

IT is difficult to predict any result with 100 % certaintly. It appears that your surgeon is being reasonable and attempting to meet your aesthetic goals but you are asking cotnradictory goals: you want a permanent reduction in areolas that was not achieved with temporary stitches yet you will not allow the surgeon to use permanent sutures. He/she sounds as  if they are doing their best to please you.

Unfortunately, spreading of the areola can occur regardless of the technique and/or sutures used. There are pros and cons with absorbable and with permanent sutures. I would suggest,  assuming your plastic surgeon is a well experienced board-certified plastic surgeon,  that you allow him to help you.

Best wishes.

Without pictures and based on your description of your breast before surgery, you have tubular breast and the for revision after implant and mastopexy is not uncommon. Please go back to your doctor and give him the opportunity to make your breasts more even. The revision rate for the mastopexy and implant is around 20% and even higher for the tubular breast. Picture would be helpful.

Regarding: "Internal Stitches for Benelli Lift?
Had my BA and also had the benilli lift. My areolas were smaller but they were puffy and stuck out. After three months one flattened and went back to the same size, and then the other popped inside and flattened, assuming the internal stitch broke? i'm upset cause i wanted my nipples smaller and now they are the same size, my doctor told me he would fix it again but i don't trust him now, he said he would use permanent stitches inside, wont that make it puffy forever?"

Miscommunication and misunderstanding between surgeon and patient is THE major reason for disappointment and distrust after Plastic surgery.

The Benelli "Round Block" Lift was never meant to do the things some surgeons put it through. It was meant for minimal lifts by removing the skin EITHER around the areola (the darker breast skin around the (raised) nipple) OR making a larger areola smaller (by removing a small amount of excess areola and skin around the areola ) and hiding the scar along its periphery. This results in a larger outer donut which needs to be made smaller to stitch the smaller inner circle of the areola (nipple complex). This is done by placing a purse string stitch (similar to a lawn leaf trash bag string) which when pulled purses and makes the outer circle smaller. The vast majority of surgeons use a non-dissolving suture here.

IF
- too much skin is taken off (as in an attempt to substitute this operation instead of a formal breast lift with a scar down the center of the breast)
- a breast implant is placed AND too much skin is removed
- the purse string suture breaks
then there is too much skin pulling on the edges of the areola (nipple complex) resulting, under the best of circumstances, in flattening of the dome of the breast, then in stretching and widening of the areola or in worse cases in ugly "sub-burst" scarring along the periphery of a large and irregular areola sitting on top of a flattened breast.

You need to understand your options before taking an action that may make breast repair very hard. I would suggest you seek a second opinion from several Plastic surgeons.

Dr. Peter Aldea

Usually the swelling after surgery may cause the areola to be a bit puffy, but this should resolve once the  swelling goes away.

This is not an uncommon occurrence.  I have used permanent sutures with good success and used a technique called a pinwheel pursestring suture which does seem to diminish the puffiness.  The other way you can avoid the areolar enlargement is by utilizing a vertical scar to decrease the outer circle diameter and therefore avoiding the need for a benelli type suture.  Probably you had the benelli because you needed only a small amount of lift and you want to avoid the extra scar.

Speak to your plastic surgeon and discuss your concerns.  It will be much more costly to go to another surgeon as well, which may be a consideration.  The problem you have is not uncommon and easily correctable.  Good Luck, Dr. Schuster from Boca Raton