One of the most common preventable aesthetic complications in performing a breast lift is widening of the areola. When the breast lift is performed, skin is removed around the areola if it is a periareolar lift, and in cases of significant breast sagginess, more skin is removed on the lower part of the breast. The problem is that when you close the skin, it tends to have a high tension, and because of the elasticity of the skin, it will ultimately stretch with time. This happens with the dark skin around the areola. This is the reason that after a breast lift, you see some patients developing widening of the areola.
One way to avoid this is by suturing the areola with a very strong suture called Gore-Tex. Gore-Tex is a nonabsorbable suture that can decrease the tension of the closure and actually prevent the areola from getting wide after surgery. During surgery, once the skin is removed, a dermal cuff is created around the areola. Then, using the Gore-Tex sutures, the areola is sutured circumferentially under the skin. Once the suture is circumferentially applied, it is tightened, bringing all the skin toward the midline and reducing the tension of the closure once the areola is approximated. Once the Gore-Tex suturing is finished, the areola is closed with absorbable sutures and a running suture. Using Gore-Tex is the gold standard to prevent this complication.