Normal for a purse string stitch to hurt?

Question

4 years ago I had a circular "donut" lift in conjunction with silicon breast implants. I was a 34D before surgery and now a 34DD. I can feel the purse string stitch through my skin and nipple and it hurts, especially where the knot is. I have been debating having them removed and getting a different lift that doesn't require a suture that would cause me trouble like this. Is this a normal outcome? Or just how my body is reacting to the stitches?

Joshua Lampert, MD, FACS · Answer

I use a gortex suture purse string technique to correct mild droop (ptosis), reduce areolar size, and adjust nipple areolar complex position.  The benifit of using a strong permanent suture is that it takes tension off the skin and prevents the areola from spreading wide.  Being a permanent material, the suture is strong and lasts but can get infected or be irritating to the patient.  This can necessitate removal.  It is difficult to say when it is ok to just remove the suture.  If they have to be removed, I generally try to replace them if it appears that the skin starts to spread.  If superficial and irritating, I try to replace them slightly deeper.  If they are infected, I first remove it and then make sure the infection is treated prior to replacement (at least 3 months).  Much of this can be performed on a stoic patient just under local anesthesia.  At 4 years postop, a significant amount of mature scar tissue may prevent areolar spread at all and simple removal may suffice.It is important that you see a board certified plastic surgeon for any and all cosmetic breast surgery!

Jaime Campos Leon, MD · Answer

Thank you for the question.To best help you, a physical 
examination is required in order to determine 
which procedure or technique would be best for your case.Dr. Campos

Curtis Wong, MD · Answer

but if you can feel the knot, having it removed should be pretty simple.  It could be challenging to another type lift after having had the Benelli as you could easily have retained areola in your vertical scar.  Perhaps a case for the "ultimate breast lift" which I have no idea of what it is.  Best to ask that surgeon for patients you can call and even better, see their before and afters and late afters to see how well they hold up with time.

Steven Wallach, MD · Answer

A purse string suture should be able to be removed about a year after surgery if it is bothersome. At 4 years it should not be a problem.

Lee E. Corbett, MD · Answer

It would be easy to remove those sutures in a quick office procedure. Your areola may widen if you do that and a new lift may be necessary though. You should see your surgeon and get their opinion.

Normal for a purse string stitch to hurt?

Answers (6)