Can you always feel the permanent suture around the areola?

Question

With breast lifts and areola reductions that use a permanent suture around the areola, can you always feel it? Or, can they be placed deep enough that they won’t be palpable? Also, can they be eventually taken out (say after a year) without fear of the areola re-stretching since there may be sufficient scar tissue around the areola then to hold it in place?

Kenneth Hughes, MD · Answer

Hello.
Great question. You do not always feel sutures around the areola. It all depends on the surgeon's suturing techniques. Please visit a board certified plastic surgeon for a detailed surgical plan to achieve   your desired results.

Daniel Barrett, MD · Answer

Dear XXxxr,
in case of breast lift, permanent suture is placed deep under skin so you can't palpate or feel it. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD

Gary M. Horndeski, MD · Answer

Yes, permanent sutures can be palpated.  However, there are lifts techniques that do not require permanent sutures around the areola.  The technique I recommend is The Bellesoma Method.  This will reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage.  Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained.  The areola is not pulled tight and therefore is closed using absorbable sutures.  They usually absorb within 6 months and therefore are not palpable.Best Wishes,Gary Horndeski, M.D.

Michele A. Shermak, MD · Answer

Hello!The Permanent Suture is not palpable and is typically placed deep to the skin. An absorbable suture layer is placed above that layer. The suture is only removed if there is inflammation or infection.Best of luck!

Mathew A. Plant, MD, FRCSC · Answer

The stitch is usually deep enough that you shouldn’t feel it during normal daily activities like washing yourself, however if you really try to feel it you’ll always be able to. The jury is still out on whether the suture can be removed after a year or so. Some surgeons say it can but in my opinion the areola will stretch out over time if it is removed. Hope that helps!

Daniel Zeichner, MD · Answer

Hi and welcome to our forum!Permanent periareolar sutures can be palpated if placed superficially. We attempt to place them as deeply as possible. These sutures can erode through the skin, requiring removal. They can disrupt, sometimes years later, resulting in recurrent stretching of areolar size. The scar is inadequate to hold the structures in place after suture removal as there are forces attempting to restretch areolar size. In addition, suturing a larger circle to a smaller circle may result in "pleating" of the suture line. Tension is taken off the closure if a vertical lift is performed concurrently as the areolar skin opening is made smaller by removal of a segment of skin at the areolar margin below the areola.Visit a board certified plastic surgeon for evaluation and discussion.Best wishes...

Connie Hiers, MD, FACS · Answer

Different surgeon use different kinds of sutures, and some might be felt if placed too superficially. I try to place mine deeply enough so they cannot be felt nor try to spit out once healed.

Douglas Taranow, DO, FACOS · Answer

Thanks for the question.  Typically, the periareolar suture is placed deep enough that it is neither papated or visualized.  I use a soft pliable "Gortex" suture which I have found better than the nylon sutures I used a decade ago.Dr T

Benjamin Gelfant, MD, FRCSC (retired) · Answer

Dear KWxx;
The short answer to your question is yes. This is one and only one of the reasons why I and many of my experienced colleagues abandoned peri-areolar lifts as unsatisfactory. In my opinion this is a procedure that despite numerous changes has never become a satisfactory substitute for a properly done, three dimensional breast lift, with vertical and horizontal tightening of the breast tissues. The trade-off is the scars with which you are no doubt familiar. But scars fade with time whereas poor shape, suture palpability, and inadequate lift do not.
Be sure you are seeing a certified Plastic Surgeon, preferably a member of the Canadian Society for Aesthetic ( Cosmetic) plastic surgery.
Best wishes
Benjamin Gelfant MD FRCSC

Can you always feel the permanent suture around the areola?

Answers (9)

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