Periareolar Lift- Permanent Suture Undone?

I am positive my left permanent purse string suture is Not connected. A couple months after surgery I saw a stitch and thought it was one that was suppose to dissolve so I cut it! I had no idea I had permanent stitches underneath. I guess is was poking out where the knot was. The appearance is bothering me when the nipple is not cold/contracted. My PS said everything was fine and it was still there. I was not completely honest and did not tell him I cut some stitch. I dont know what to do now!

Doctor Answers 6

Periareola stitch

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First, you shoudl always be honest with your surgeon. Second, if the permanent suture was cut it may lead to widening of your areola.

New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Periareolar Stitch Cut and Areolar Widening

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   If the periareolar stitch is cut, this will tend to cause areolar widening, particularly in the early postoperative period.  If you inform your plastic surgeon that the stitch was cut, this will provide for a better exam and to help in your overall care.

Patient-cut periareolar suture--areola will eventually stretch out.

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What you did was unfortunate, but I've had patients do similar things as well. Being honest with your surgeon is a good thing (especially since you expect the same courtesy from him), but he will eventually figure this out anyway, since your areola will stretch (more) compared to the opposite side where the suture is still intact, requiring local anesthesia revision.

Even though this is technically "your fault," if you were my patient I'd still not charge you anything but a small operating room fee (no surgeon's fee) for the revision.

I'd recommend 'fessing up and offer to pay the operating room fee for the local anesthesia revision; your surgeon may just offer to do this as a very low cost office procedure if he is so-equipped. You should probably wait for at least 3 months (6 months is better) before re-do surgery is performed; it may actually take at least that long to firmly establish that you cut the permanent purse-string suture that should have remained intact--if you did, the areola WILL stretch as time goes by. Best wishes! Dr. Tholen

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
4.9 out of 5 stars 263 reviews

Concerns about Areola Symmetry after Cutting Suture?

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At this point, I would continue to follow-up with your plastic surgeon and discuss your concerns/questions. If the areola spreads as a result of a permanent suture being caught, revisionary surgery may be necessary to improve the areola symmetry. Often, this procedure can be done under local anesthesia. 

 Best wishes;  hopefully, you'll be very pleased with the long-term outcome of the procedures performed.

Permanent Suture

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The most important issue to address is being honest with your surgeon.  It is not possible for the surgeon to give their professional opinion without knowing all the facts.  It does sound like the permanent suture purse-string remains intact if your surgeons says so as this is usually easily felt.  Good Luck

Gary A. Tuma, MD, FACS
Princeton Plastic Surgeon

Periareolar Lift- Permanent Suture Undone?

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If your surgeon examined you and told you the pursestring was still there, it most likely is. It is pretty easy to feel, and follows the course of the circular scar around the areola. In that setting, you most likely did cut a dissolving suture. If the pursestring is gone, that areola will get larger than the other. Best wishes. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.