I have my in office procedure scheduled on Monday! I am very nervous but trust my surgeon who said he can make a lots of improvement w/ my scars around areolas. My scars are from benelli lift + augm in 2004 performed by another surgeon. I am content for now with the way my breast look after explant ( 8 months post explant of silicone 390cc). My priority is to fix these scars which i have been bothered by for a long time. Any tips on sutures etc???? Thanks
Am I Doing the Right Thing with Periareolar Scar Revision? (photo)
Doctor Answers 17
Periareolar Breast Scar Revision
There are three things that cause scars like the ones you have. They are wound tension, how the incision was closed and your skin/dermis. You no longer have the tension you had when the Benelli lift was done, so that should improve the result. When a scar is revised, the suture should be strong enough to resist what tension is present and last at least six months until the scar is strong enough not to stretch any further once the suture is no longer supporting the wound. For this, I use a larger than normally needed PDS or permanent suture. You cannot do a lot about the latter, but deepithelializing the scar between the incisions and using that dermis as further support with another layer of the above sutures can help some. A good Plastic Surgeon should know all this. Good luck.
Periareolar scar revision.
Revision of the periareolar scars is a common procedure. These scars are often widened and unattractive when they are performed at the time of a breast augmentation (augmentation mastopexy). This is a normal response of the scars to the increase in tension from the augmentation. At this point, particularly following your explant, these scars are likely to heal with much more predictability.
Fixing a periareolar scar
The problem is that when the first surgery was done, a large circle of skin was sewn down to the areola and now by removing the scar, the outer circle is effectively bigger than the first one was. So why would it heal any better in the long term? Maybe if a permanent suture wasn't used the first time.
But if you really want the best areolar scar, a full mastopexy will allow the areola to be put into a circle of exactly a 1:1 size relationship and the extra loose lower pole skin you have will be tailored out in the vertical and crease scars, not into the areola. This is probably not what you want to hear, but this will give you a far superior shape to what you have now (tighter, more conical projection) and will give better (though more) scars. Good luck.
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Periareolar scar revision should improve your scars, but...
I do think that meticulous technique and a careful postoperative scar protocol will give you a nice improvement in the appearance of your scars...
On the other hand, I think that overall, the improvement in both these scars and the shape of your breasts would be greater with a vertical breast lift.
Areolar scar revision bilaterally.
You appear to still have quite a bit of breast tissue and may like the results with a limited scar revision for the areolae. this revision should give you a more balanced areolar skin scar than you currently have. If done properly this would be a better result.
Good luck to you.
Scar revision around areolas
I believe you will see much improvement if revision is well done. I prefer using a permanent purse string stitch to minimize re-stretching of scar. It prolongs the lift and is esthetically more pleasing in the long run. Best wishes, Dr. H
Periareolar scar revision will work well if tension is reduced
One of the most significant problems with widening and thickening of the periareolar scars is tension across the incision, leading to irritation of the wound and thickening of the resultant scar.
The most important element of decreasing the scar response is to decrease tension across the incision and weight of the breast. Structural changes supporting the breast gland are important, and in-office treatments simply focused on the skin are seldom successfull.
Secondarily, direct skin treatment with silicone patches and prolonged skin immobilization can also contribute to improving the final outcome.
Revison of the Bennelli scar
The Bennelli lift, or around the nipple scar is prone to spread with recurring breast ptosis, and at worst have a 'star burst' pattern around the nipple. Now that the large implants are removed though, there is a better chance that a revision of the scar will reduce the spread and irregular pattern. The revision is a good idea if well done.
Best of luck, peterejohnsonmd.com
Difficulties in scar revision after periareolar breast liftslifts
No matter how good the technique or meticulous the closure the surgical realities are stacked against a PERMANENT improvement. The removal of the outer spread scar will create a much larger circumferential defect. When this is pulled inward to join the smaller circumference of the areola something has got to give. either the areola spreads unestheticaly or the scar spreads as it did in your situation.
Great chance for improvement
Your original scars healed this way due to tension perhaps from the size of the implants that were put in at the same time. But they also may have healed from your own gnentic tendency to heal your scars this way. Having them re-done now makes sense and they just might heal completley differently without the tension you had before. Ask your surgeon about ways to reduce scarring from post surgical gels and ointments as well. I hope all goes well for you.