Permanent sutures following Mastoplexy

[Tonytony]

So I have my surgery on the 1st of March which will involve some skin removal, lipo and glandular removal. As there will be skin removal, my surgeon is using a method known as a ‘donut’ skin removal. This is necessary because I have had large weight loss and the skin no longer has elasticity.

It involves cutting a 'donut' of skin from around the nipple, and then bringing the other skin forward and stitching it with gore-tex suture which will be there permanently.

While he has done this successfully dozens times and the scarring is minimal, I am a little daunted by the fact that I will have the stitching under my skin for life. What if it breaks at some point 20 years down the line or through someone pushing my chest or too much exertion? How tough are they exactly? Would I be walking on eggshells the rest of my life? I enjoy jogging and exercise and would hate for them to be hampered.

Doc seemed really relaxed and confident about it but I could do with some reassurance. I saw a photo of a previous patient’s chest and he looked pretty amazing considering the amount of skin and fat that was removed. As I don’t have a particularly hairy chest he said that the chances of infection are around 1% which seems like pretty good odds to me.

The doc must have chosen this approach for a reason, however, I was just wondering what your expert opinions on this may be? Is there significant risk, or assuming my surgeon is very skilled, will they be resilient and unobtrusive to my life?

Many thanks for any opinions.

[Dr. Elliot Jacobs]

A "donut" mastopexy is one of several alternative methods used to deal with malpositioned nipples and excess, lax skin.

The goretex suture is used to keep the diameter of the new areola from spreading outward.  Yes, it is permanent -- and it rarely breaks -- but once everything has healed (a few months), you need not worry about it all.  Sometimes, one can actually feel the circular suture under the skin -- you can talk about this with your surgeon.  On rare occasion, one can have a minor procedure one or more years later to remove the suture -- it will have done its job and is no longer needed.

Good luck!

Dr Jacobs

[Litlriki]

"Donut" mastopexy as part of gynecomastia resection is a very nice option for skin reduction in the appropriate patient, as it minimizes the scar while tightening the skin and giving better contour to the chest.  I also use a gortex suture in many of my cases to help maintain the smaller diameter of the areola, but as Dr. Jacobs indicated, after a period of time, the suture is probably no longer needed, and it can be removed if it's palpable or bothering you in some way.  In most cases, the patients never realize it's there.

Good luck,

Rick Silverman

[Tonytony]

Thank you both for your replies - I feel more reassured about permanent sutures now. 3 Weeks to go till I'm on the chopping block! Cheers