Unusual post surgery problem

[Strce1]

Doctors:  I know you generally don't recommend 360 incision donut lifts but I didn't know the difference at the time and that is what the surgeon recommended, and I don't know that it wasn't the best option for my situation.  It is done.  Breast tissue removal and lypo. More on left side. My problem is related to that 360 incision.

At about 4 weeks when I changed the strips at home I saw the left areola looked okay, the right didn't look as good.

There was a spot on the incision line that had a scab.  When I changed that strip to start wearing silicon  sheets the scab came off and I saw what looked like white string in the spot. Then a few days later the end of the string appearing.   This was at about 5 weeks. Then a spot appeared on the other side of the aureola and started to bleed.   I called the office and went in.    They said it was unusual but my body was rejecting the deep sutures...as if it was a splinter or some foreign matter.  The PA and surgeon discussed it and at 6 weeks-where we were- the sutures could come out.   It was the knot that was coming out.

So the PA took out the suture and put on surgical strips.   Today I took off the strips.   My aureola has enlarged.   Considerably.    I am quite upset.   Obviously I am going to soon consult with my surgeons office, but at this moment I feel I need some feedback and perspective on this.   Have you heard of this?  Is there anything that can be done about the enlarged aureola?   The other (left) side seems fine.

Please forgive typos.  I am posting this from my phone.

[Dr. Elliot Jacobs]

Whenever there is a total peri-areolar incision, the standard type of closure is to use a "purse-string" suture, which is beneath the skin and is usually permanent in nature.  The purpose of the suture is to hold everything tightly together so that there is no spreading out of the areola.  If there is any infection or opening of the skin near the suture, and it becomes exposed, then the best recourse usually is to remove the suture.  This will allow the wounds to heal -- but the natural course of healing is to allow substantial spreading out of the areola -- just as you described.

In most cases, the best course of action is to allow everything to heal and soften (often about six months), then return to the operating room and try to fix it again with another suture.

This is just the scenario that is all too common and exactly why I virtually never perform this type of procedure.  With properly performed gyne surgery, the diameter of the areola will shrink on its own -- without a permanent suture.

Best to have a sit-down discussion with your surgeon as to what is going to happen and what he can do about it.

Best of luck!

Dr JAcobs

[Strce1]

Thank you.  That is pretty much what I have now been told.  I'll need to wait some weeks for more healing to occur, then it can be determined what needs to take place.  I've been assured that in the end I will have symmetrical areolas.  I am quite distressed about this setback.  But I am also glad there are steps that can be taken to correct it.

Thank you for your response.

I would just like to add for anyone reading this: Try not to let the fear of things that can go wrong keep you from considering the surgery.  Just take the advice from this forum and asks lots of questions up front during consultations.

In spite of this distressing setback, I remember well the first time I saw my new contour after surgery.  I may have cried a little I was so happy.