Periareolar Closure With Barbed Sutures.

Periareolar closure in augmentation, mastopexy, and breast reduction has evolved dramatically over the past 10 years with changes in technique and technology. Plastic surgeons have tried many techniques from simple purse string closures using permanent sutures to interlocking purse string closures with GORE-TEX (Gore Medical, Newark, DE) or absorbable sutures. Running and interrupted suture techniques or combinations of both have all been utilized. I began using absorbable barbed sutures in 2007 for abdominoplasty to eliminate knot tying and decrease complications associated with permanent sutures such as knot palpability, extrusion, and infection. I then applied this new suture technology to surgical closures of the breast and developed a technique for periareolar closure that has improved my efficiency.