Q: Tubular Breast with Mastoplexy: is a Permanent Purse String Suture Needed?
I have asymmetrical tubular breast and have been told that I need a concentric mastoplexy and augmentation. I have been told by some doctors that they always do a permanent purse string suture to keep the nipple from expanding. Others say that you can always feel this suture and that it is not necessary. I do not want my lover to be able to feel the suture when we are intimate. Is it necessary and what are the risk of not doing it?

A: Tubular breast correction with mastopexy
It is hard to tell for sure from the side view, but you do not seem to have too much asymmetry. I would stay away from any permanent pursestring suture. In general the periareolar mastopexy which requires a pursestring suture has the risk of release of that suture and delayed deformity around the areola causing radial striations that are difficult to fix.
If the asymmetry warrants more than a conservative periareolar reduction I have found that the full mastopexy creates complete release of the deformity and have been able to achieve excellent symmetry between the breasts. I recommend using implants on both sides so that the symmetry is more readily achievable.