THE DOUBLE INTRADERMAL CONTINUOUS (DIC) SUTURE TECHNIQUE FOR THE ROUND BLOCK IN PERIAREOLAR MASTOPEXY.

Abstract

The most common complications following periareolar mastopexy relate to the areola: periareolar scar enlargement, areola enlargement, and areolar deformity. The polytetrafluoroethylene (Gore-tex) interlocking suture is controversial, as it may frequently suffer extrusion and must sometimes be removed, as published in the literature. We have used for more than 35 years in 520 patients a suture technique named "DIC" (Double Intradermal Continuous) suture. This technique is based on two intradermal concentrical nylon sutures that start at two opposite sites over the areola, which are tightened in opposite directions. The areola is undermined, and the internal suture is tightened to a diameter of approximately 3 cm to narrow the subareolar ostium and prevent areolar protrusion. This suture technique differs from Benelli's original one. It presents several advantages since it can obtain a round areola by applying a double suture at the opposite cardinal points of the areola. Oppositely, the Benelli technique frequently creates an elliptical areolar shape since the round block is carried out by a single suture that follows a single vector. Furthermore, using two concentric sutures, besides decreasing the risk of rupture of one single suture, also diminishes the risk of areolar widening. A further advantage of using nylon is that this material is very well tolerated, and its extrusion is extremely rare. The scarcity of complications and its considerable advantages have increased the value and reliability of our DIC suture technique for RB in periareolar mastopexy, tuberous breasts, and all vertical and inverted T mastopexy and breast reduction.