The Double Intradermal Continuous Suture Technique for the Round Block in Periareolar Mastopexy

The most common complications after periareolar mastopexy relate to the areola: periareolar scar enlargement, areola enlargement, and areolar deformity. The polytetrafluoroethylene (Gore-Tex) interlocking suture may lead to extrusion and require removal. The authors have used the double intradermal continuous (DIC) suture technique for more than 35 years in 520 patients. The DIC technique is based on 2 intradermal concentric nylon sutures that start at 2 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 the technique described by Benelli. The DIC suture technique can obtain a round areola by applying a double suture at the opposite cardinal points of the areola; the Benelli technique frequently creates an elliptical areolar shape because the round block is carried out by a single suture that follows a single vector. Furthermore, using 2 concentric sutures, besides decreasing the risk of rupture of a single suture, diminishes the risk of areolar widening. A further advantage of using nylon is that this material is well-tolerated and its extrusion is rare. The DIC suture technique for round block, with its scarcity of complications and considerable advantages, is useful in periareolar mastopexy, tuberous breasts, vertical and inverted T mastopexies, and breast reductions.