I just had breast reduction surgery. The scars seem to be settling, and I want to know what to put on them to minimize their appearance.
How Can I Minimize Scars from Breast Reduction?
Doctor Answers 27
It is amazing how nice the incisions look after several months.
If you just had breast reduction surgery, listen to the recommendations of your plastic surgeon. Most surgeons prefer surgical tape or strips for the first few weeks. You can then progress to silicone sheets. However, they must be worn almost 100% of the time for several weeks to months to make a difference. The best thing for you to do right now is just wait. After your surgeon gives you the okay, I would recommend gentle massage over the incisions to help them soften. Scars/incisions go through a maturation process where they actually get slightly thicker (like a cord under the skin) as the collagen is rebuilding for the first six weeks. Then, over several months the incisions soften up and flatten out. When patients come back six months to a year out from surgery, it is amazing how nice the incisions look. As with all incisions, you should protect them from the sun with either clothing or SPF lotion.
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Breast Reduction Scar Management
A: Reducing Breast Reduction Scars
I have switched to a "lollipop" type of incison/scar for breast reductions which reduces scars by about 50 % vs a traditional anchor pattern scar.
Scar Management tips:
- Minimize tension on the scar. Embrace scar dressing is the best as it lessens tension directly on the wound. 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 preventshyperpigmentation (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.
For best scar managment in general see my below link on best practices for scar managment.
Best ways to minimize scars after breast reduction
A good supportive bra is effective because it prevents excessive tension, which can stimulate scar formation. The application of pressure to a scar is also effective. Patients can apply paper tape or use a silicone gel pad if more specific pressure is needed. A scar takes approximately 6 months to a year to reach maturity, so be patient.
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Breast Reduction and Scarring?
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. 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.
Scar sheets work well after breast reduction
Week only recommend that our patients used silicone scar sheets after a breast reduction surgery. These sheets help the scar heal in a flat and smooth fashion. The best scar sheets are typically found not in the pharmacy online. There are several vendors that are particularly effective. If you would like a list of vendors that may help please feel free to contact our office and we will forward the information to you.
The best way to minimize the appearance of scars
For many years I have used paper tape on my patients' scars. I have found that this works the best; better than silicone sheets and other products. I use 1" paper tape that is brown is color, so it does not show through clothing. The tape is put on so that it is a little tight. The patient reapplies it when it is loose. The pressure from the tape helps the scars heal very nicely. Hope this helps.
Tracy M. Pfeifer, MD, MS
Tincture of time for most people
That is a very common question. The majority of peopl will heal fine without any topicla type treatment( silicone tape or sheeting, or topical salves). So, I always say that tincture of time is often the best medicine. That being said, I like to keep steristrips or paper tape on the incisions for at least 3-4 weeks.
Scar Massage Management Following Breast Reduction
Kelo-cote to minimize scars
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.