Stretched Areolas After Benelli-- Is The Cause Not Enough Support Post Op?

Hi,

  It is diifficult to answer your questions without a picture but here are the facts of the donut pexy (Benelli lift).

  The patient most often does not want a vertical scar on the breasts so the donut pexy becomes the least noticable approach to lift the nipple complex with two circles drawn on each areola.  The outer larger circle is around the areola and the recipient site for the areola.  The inner circle is the size of the areola size that is desired.  The tissue between both of these circles is now excised and the remaining nipple areola is raised to the new position and the tissue between is tucked inward as the two circles come together.

  In so doing, especially with a very large movement, there can be a flattening of the breast.  This is because there is a push of the tissue as the circles are joined.  Sometimes this is noticablle but many times an acceptable tradeoff.

  The areola spreading occurs because the forces on the incisions with the breast tissue being compressed will "drag" the borders of the areola outwardly from the center mark of the nipple bud.  There is no locking point that a vertical scar provides.

  I am very specific with the areola spreading issue with the donut pexy for patients with tubular breasts. I show pictures of the spreading.  Some patients want to try to prevent it from happening and the vertical locking at 6 o'clock will help prevent it.  Some patients will accept the spreading.

  Do not blame yourself for this occuring. Wearing a bra or not is not the key to it happening.  It just can happen.  As mentioned, the longer the distance between the original position of the areolas and the recipient place for the nipple complex, the more chance you will have for areola spreading. 

   The spreading may continue.  Discuss your options with your plastic surgeon and come to a conclusion as to the approach to correct it.  In my practice, I suggest the vertical (I know, who wants it) incision to "lock" the circumference of the areola ( you will need the excess outer rim of the areolas removed to move to the normal size again).  Another step can be to place a permanent stitch in the tissue around the areola.  I find that it is difficult to get consistent accuracy of symmetry with this method.

  Talk to your surgeon.  It can be corrected and perhaps more predictable for the future.

A Benelli lift is performed around the areola border. There is a yin/yang thing going on pulling by the areola one way and the skin around the border in the other way. I use a permanent sutures around the areola to limit the pull out so that the areola does not stretch too much.  You shold ask your surgeon how he did his procedure and watch closely.  The areola stretch can be revised.