I am 18 years old and considering a breast reduction and lift. I want to have this surgery done so bad but my only concern is the scarring. Therefore, how bad are the actual scars and will a type of cream or lotion help reduce the appearance? HELP!
Breast Reduction and Lift Scarring - How Bad Are They?
Doctor Answers (15)
Scars and breast reduction
Breast Reduction/Lift scar Reduction
Best Scar Management is important to minimize or completely hide from view, the telltale signs of your surgery—namely, scars. Both you and your surgeon want you to have the most minimal scarring possible. There are many possible causes for scars that are enlarged or not healing well. Unsightly scars are most commonly due to genetics, underlying medical conditions, or improper scar/wound care. The last part is very important and patients can make a noticeable difference in their scars’ appearance by following best scar management practices. Here are some simple tips.
Scar Management tips:
- Minimize tension on the scar. Steri-Strips and/or surgical tape are often placed in non-hair bearing areas to minimize tension and keep pressure over the scar. This minimizes the stress that can pull the scar apart (dehiscence) creating a wound and delaying healing time, and can make the scar wider, or more “ropy”.
- Keep your incision site/scar clean to prevent infection. Follow your surgeon’s wound care instructions to the letter with out modification. Never apply different products then recommended without first discussing them with your surgeon. This is especially important during the first few weeks. If there are any signs of infection, contact your surgeon’s office right away and/or see your doctor or his nurse immediately. Typical signs of infection may include redness outside the immediate incision site, asymmetric swelling, and drainage, of pus, fever, chills, and “feeling sick”.
- Protect your scars from the sun. Staying out of the sun is the best advice. Minimal exposure to sunlight is prevents hyperpigmentation (permanently turning brown) and other problems that can make the scar more noticeable. Sunscreen, at least 30 SPF and an overlying make camouflage make up additionally protects the scar from the suns harmful rays. This advice is especially important the first year following your surgery.
- Use specific scar maturation products recommended by your surgeon. Patients seem to have their own opinions on this touting everything from Pure Vit E, Coco butter, to Aloe Vera, etc but most have minimal benefit other than keeping the scar hydrated. Although hydration is important there are better, scientifically studied products with greater efficacy. Most of the scientific articles written about this subject indicate that topical silicone gel or silicone sheets work the best. There are a lot of products to choose from, but silicone should be one of the key ingredients. Although Mederma, an onion extract derivative active ingredient rather than mainly silicone based may help, primarily silicone based products are better and many also contain other ingredients that may be synergistic (hydrocortisone or other steroid, Vitamin E, Sunscreen,etc). At the present time I prefer BioCorneum or Kelo-Cote products especially on areas that silicone strips aren’t applicable, for example, on the face. If the reader has problems obtaining these they can call my office. Patient compliance is also critical – use often and according to directions or it will not work optimally. NEVER apply products without first discussing them with your surgeon.
- Monitor to make sure your scar is progressing optimally. Keep your scheduled follow-up appointments with your surgeon to verify that your scars are maturing as expected. Occasionally if indicated you may need a topical steroid preparation or even a series of injections (5-FU and/or Steroids) or laser treatments to treat or prevent scar hypertrophy or keloid formation (red raised scars), or other topical medicines to treat post inflammatory hyperpigmentation (brown scars) with prescription creams and possible laser treatments.
Breast Reduction Scar Management?
Breast reduction surgery is one of the most patient pleasing operations we perform. Although there are many benefits of the operation patients should consider the presence of scars ( and the potential for unsatisfactory scarring) in their decision-making.
Time tends to improve the appearance of scars. You will find that the scars will improve in appearance even after a year has gone by. Sometimes the use of silicone-based products can be helpful. In the event of unfavorable scarring steroid injection may be helpful. The use of superficial radiation treatment is possible for symptomatic scars. Sometimes scar revision surgery and careful scar management afterwards may be helpful. Despite anecdotal reports I have not seen significant improvement with laser treatment of scars.
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Predicting scars from breast lift (mastopexy) and reduction
There are no magic creams that will prevent scarring. Scars are 50% the surgeon's technique and 50% your genetic response to that injury which cannot always be controlled. Scars can range from very fine white lines to to thick rope-like scars and everything in between.
Scars after breast lift can be minimized
In order to get the best shape and size of breast with a lift some incisions around the areola and under the breast are necessary. In most patients these incisions can be very minimal after four to six months with proper care. This care begins in the operating room with layered closure and minimal sutures on the surface. This is followed by prolonged scar therapy with proven techniques of placement of special sheeting over the scars for an extended period of time. In the event a bad scar is incurred then a scar revision may be required.
Tal Raine MD
Breast scars in lifts and reductions
There are mainly three factors involving permanent scars that are required to lift and/or reduce breasts. These are their length, their location, and their appearance.
Experienced plastic surgeons today can limit the extent of the scars on the breast to around the areola and from the areola down to the inframammary crease (a "lollipop" incision) and can close the incisions as well as anyone can, but there is no way to guarantee how they will look or how you will feel about them.
As for reducing scars or their appearance, there is nothing that actually works to improve on normal scarring. There are some things that can be done to limit or reduce abnormal or excessive scarring but have no influence on normal healing/scarring and pigmentation. Most of the creams and topicals are wishful thinking but probably won't harm anything.
When breast scars are fully matured (can take a year or more) it is reasonable to consider permanent makeup for them which is tattooing in skin color, particularly around the edge of the areola.
Breast Reduction/lift scars are permanent, but can be minimized
There are many short-scar, "lollipop"-type procedures that can make scars shorter after breast lift/reduction. There are also creams, dressings, and lasers that can be used to help scars look more attractive over time. But you will have permanent scars, period. Meet with several surgeons and look at their before/after photos to get a good idea of the typical scarring after such surgery. Nobody can promise you a great scar--a lot depends on your own body's healing ability and scarring tendencies. But a good surgeon will work with you to make your scars the best they can be over time. Scars take a year or more to fully mature, so you should have follow-up visits with your surgeon for at least that long.
Breast reduction and scars
Yes, whenever a surgeon performed surgery on any body part their is always a scar from the procedure. There are many variables contributing to the quality of the scars but these can be reviewed during your exam. They can heal very well.
Women accept breast reduction scars if they love their new breasts.
1) Most breast reductions and lifts can be done with a vertical (lollipop scar) technique. This is a minimal scar approach. The scars fade a lot but do not disappear.
2) I can tell you that I hear a lot of worry about the scars before surgery. After surgery, I very rarely hear about the scars, and it's not because they are gone. What happens is that the patient realizes that she has made a very good trade off.
Breast Reduction and Breast Lift Scars are Acceptable especially with Short Scar Techniques
Breast Reduction and Breast Lift scars are identical. In the vast majority of women they can be done as Short Scar Techniques with only a Lollipop or balloon shape scar instead of the vertical T / anchor shaped scars. See a Plastic Surgeon familiar with the Short Scar Technique and find out if you are a candidate for it.
The vast majority of our Breast Reduction / Breast Lift patients are extremely happy with their results despite the scars which become quite acceptable.
Dr. Peter A. Aldea
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.