My scars are hypertrophic and unsightly. I am overall pleased with the breast aug but the scars make me feel like I've swapped one set of issues for another. I am using silicone strips but am not satisfied with the results. My surgeon is sort of dismissive about them and just want me to wait it out. Do most surgeons provide kenalog/cortison shots post-op or is it common to have a surgery and then have to find another doc to take care of the scars? Please post suggestions for my scars.
Breast Aug Scars - 4 Months Post-Op
Doctor Answers (14)
Surgical scarring and scar widening
I cannot see why your plastic surgeon would not or could not take care of the scars after surgery. It is part of the surgery aftercare that you paid for when you paid for surgery and within the realm of plastic surgery. Most prospective patients do not seem to understand that when they are doctor shopping. Surgeons that routinely under charge to get a case from competitors will frequently not be able to deliver the required after care because they are forced to move onto the next patient as they have to treat more patients per unit time.
My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.
Laser treatment for scars
I would consider laser treatment for these scars. In Miami - dermatologist Jill Waibel would be who I would see.
Breast augmentation scar position and tension
I think your scars are well above the infra-mammary fold, and in that position are subject to significant tension from the underlying implant. I think the measures you have taken so far will improve the scar, but will not change the position. Scar massage is also a very effective means of softening scars. Follow up with your plastic surgeon !
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The first thing I would recommend is to discuss the scars with your surgeon. There are a number of potential actions. Pressure often with silicone can be used to aid scar maturation and flatten hypertrophic scars.Steroid injection is also a possibility to flatten scars. In general incisions look their worst around one month then slowly mature with time often it can take one year.
Four months post op is still too soon. I would suggest waiting at least a year or 10 mo. at the soonest to start interventions. If the scars are red, you could start treating them with a laser like the v-beam or an IPL if they are very vascular and this can sometimes reduce the redness, possibly some shrinkage as well. Steroids can be implemented when the surgeon feels the scar is mature enough for that intervention.
Breast augment scarring
Breast augmentation scars
Your plastic surgeon may be overly dismissive but the reality is that there is little that can be done to improve hypertrophic scars or speed up the maturation process. Pressure can soften scars and speed up maturation but it's unrealistic in this location. Steroid injection will speed up the maturation process but won't change the width, length, position, or color of the scars. I would condemn the idea of laser treatment and scar massage or topical treatments are also wishful thinking. Occlusion with something like silicone sheeting may help speed up maturation but won't really change the outcome.
The best that we can do is to limit the length of the incisional scar to the minimum, control the location of the scar, make sure the patient understands the scar tradeoff, close it as well as can be done and minimize healing problems, and avoid irritation to the scar while it is trying to mature. In your case I would agree that the implant may have been too wide for the position it was to fill, the incision rose up on the underside of the breast, and the length of the incision does not appear to be the minimum that can be done today (about 3 1/2 cm with a Keller funnel for silicone gel implants -- 2 cm for saline-filled implants). Unfortunately there is nothing you can do to erase the scars and start over so you will have to consider steroid injection or allow full maturation over a year or more.
Scarring After Breast Reduction
There is a great deal of variation in the quality of scarring following breast augmentation or any operative procedure for that matter. The only reliable predictor is previous scar formations. It does appear from your photos that your scars would benefit from injection of steroid (I add another medication to the steroid which I feel improves the result). I personally would charge only your insurance company or my actual cost of supplies for this service, but this will vary among surgeons.
Breast aug scars
Usually your plastic surgeon would want to follow you for your scars but they may take up to 12 months to mature. Silicone strips are an option for now. Later on kenalog can be used but I would wait at this point. Discuss it with your plastic surgeon.
Several options for scar treatment
There are several options for hypertrophic scars post surgery. It does however take 6 months to one year for complete scar healing. I'm glad to hear you are wearing silicone patches since they are a great option. Manual scar massage is also a good option but typically during the early recovery period (1st 3 months) If between 10-12 months your scars are still raised and thick speak with your plastic surgeon about kenalog injections. He or She should be able to offer that treatment to you in their office.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.