Double Purse String Closure Technique for Minimizing Post-Operative Widening of Periareolar Augmentation Mastopexy: A Comparative Study

Boughdadi, Nahed S

doi:10.21608/ejprs.2020.68160

Double Purse String Closure Technique for Minimizing Post-Operative Widening of Periareolar Augmentation Mastopexy: A Comparative Study

Document Type : Original Article

Author

Nahed S Boughdadi

The Department of Plastic and Reconstructive Surgery, Faculty of Medicine, Ain Shams University, Cairo, Egypt

10.21608/ejprs.2020.68160

Abstract

Objectives: For management of mild degree breast ptosis
periareolar mastopexy had been commonly used. Since Benelli
1990 had confined the scar to the areola in his round-block
technique, several authors has adopted this technique. Whether
mastopexy had been done with or without augmentation, the
problems of breast shape, areolar irregularities,and stretch of
the areola had been annoying to both patients and surgeons.
These problems also represent a major challenge to this
technique. In this paper purse string closure was used in two
consecutive different layers one in dermal de-epithelized layer
and another in the deep dermis of the skin. The aim is to
minimize widening of scars of peri-areolar incision and
improve its long term appearance.
Patients and Methods: 50 cases underwent mastopexy
with breast augmentation. Cases were divided into two groups:
Group A: Underwent closure by single purse string layer and
Group B: Two consecutive purse string closure. The second
concentric row was applied to the deep dermal plane of the
normal non de-epthelialized skin similar to the classical purse
string closure described previously. Both subjective and
objective evaluation were done. Surgery was done by single
surgeon and two surgeons not involved in research evaluated
the post-operative photos. Follow-up was done at 3, 6 month
and at 1 year post-operative.
Results: Group B patients showed superior results as
regarding breast shape, contour, projection, superior fullness,
periareolar scar shape, regularity, areola width and position.
These results were followed-up for one year.
Conclusion: Decreasing the tension of the periareolar suture
by applying double purse string technique in two different
planes improved long term results of periareolar scar in order
to avoid widening, irregularities and hypertrophic scarring.

Keywords

Breast ptosis – Periareolar – Mastopexy – Augmentation

Main Subjects

Aesthetics

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