I am considering a breast reduction. I have breasts that are FF! I am only 23, 5 ft 2, and I weigh about 135 pounds. I have tried to loose weight, but my breast stay large. I have always been self conscious about the way my body looks and would love to have a reduction, but I don't want the ugly scars. Is there any way to have a reduction without large scars? Another concern is my breasts are slightly starting to sag. If I were to leave them this size could they be lifted without scarring?
Breast Reduction Scars - How to Avoid Scarring?
Doctor Answers (49)
Breast Reduction / Breast Lift
The procedure for Reduction/Lifting of the breasts will vary with what you would like to achieve. Some visible scars will result but these can be minimzed with proper surgical approach and pos operative care.
Adjunctive treatments with IPL can speed up the reduction of red color of the scar.
We use long acting freezing in the tissue which minimizes/eliminates post operative discomfort.
With Kind Regards, TMB.
You will have some scars.
Hi! I bet you would be happier with a breast reduction. We now can do it with less scarring. You would need a "lollypop" scar. The scars do fade a lot but they don't disappear.
I can tell you that women worry a lot about the scars before surgery, but after surgery, I hardly ever hear about them. They are there alright, but the patient is happy anyway because she feels she made a good trade-off.
Breast reduction without large scars
Your research will probably lead you discussion of "scar-less" or "minimal scar" surgery. For years US and international surgeons have trying to develop ways to give patients superior results with little scaring. Alternatives such as liposuction of fat, leaving glandular tissue and skin have been tried.
National surveys and informal polls at national meetings confirm that the majority of surgeons feel that short scar techniques (lollipop or vertical plus areolar edge) are suitable for smaller amounts of reduction and lift (mastopexy, without reduction of size), and that larger scar techniques (inverted-T or Wise pattern) are best when reducing many cup sizes of lifting many inches. My practice generally conforms to this pattern.
I do believe that heavier breasts can sag more over time, although that is not always the case. I doubt that you will have long-lasting success leaving them large and lifting them. If you had a lift (without reducing the size) gravity will continue to work on them.
Scars certainly look prominent in photographs, particularly the more recent ones. We show patients many Before & After photos during their consultation and they decide if they will be more comfortable with scars and improved breast & body contour, or if scars are unacceptable. Meet with several experienced plastic surgeons, and look at their photos before you make your decision.
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Avoiding Scars with Breast Reduction
You have my sympathies in trying to cope with such large breasts. You must be quite uncomfortable, both physically and emotionally.
The good news is that you do have options to alleviate the problems your experiencing. Breast reduction can be quite powerful in relieving symptoms and improving self-image.
Other than weight loss, there are some very new techniques of fat reduction that use freezing or ultrasound. Their efficacy has not yet been reported in our leading and respected journals. I am not aware of their application to breast reduction; it is possible that these non-surgical techniques may apply to breast reduction, in the future; I can't recommend them, at this time.
Liposuction would require 2 or more ~1/4-inch incisions in the breast creases and/or armpits
Liposuction and non-surgical techniques do not address shaping or lift. They will deflate the breast to reduce size.
As large as you are, the deflation may leave enough sagging that you might really want the lift, which leaves you with the scar you are trying to avoid.
The answer for you is “NO.”
The answer for you is “NO,” but there are many things that can be done to minimize the scars. From your question, you are interested in reducing the size of your breasts as well as having them with no “sag.” You can reduce the breasts with Liposuction using only very small scars. The trade, however, is that the breasts will sag in proportion to how much you reduce the breast. To reduce the breast and set it up a minimum of a scar around the areola and one either from the areola to the chest or one under the breast is required. This is less than what we used to do. Other modifications in closure technique (such as using a “dermal bra” and sutures that remain in buried place until adequate scar has developed) can also improve the scars. The only way to decide what to do is to talk with an experienced Plastic Surgeon who has several methods at his/her disposal to achieve what you desire.
Reducing Breast Reduction Scars
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 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.
For best scar managment in general see my below link on best practices for scar managment.
Breast reduction - minimising scars
Breast reduction without scars
As a double F who is 23 yrs. old with short stature, a reduction/lift would seem to be in order to restore the balence, equiliibrium and harmony of your upper torso to prevent the negative sequellae which are sure to come.
A reduction of this magnitude cannot be done without scars. SCAR IS THE BODY'S GLUE, AND THERE CAN BE NO HEALING WITHOUT IT. Once they have done their job, scars can be managed with: patience, pressure and medications.
This is the trade off that you will have to make, and in my experience over 35yrs., patients have considered it well worth it.
Breast reductions have options
The two main components of breast reduction is size and shape. If you are only concerned about size/weight, then you can remove fat or even the gland through small incision. But you could shape the breast very well if you have excess skin. The more shaping you desire or need, the more scars you will need. There are a few options using scars that are less than the traditional inverted-T or anchor scars. There may be some compromise in ability to shape. You need to sit down with an experienced plastic surgeon and carefully go over the options. I have rarely had to use the traditional incisions and usually can use these shorted scar technique and occasionally just liposuction. Cosmetic sugery often requires trade-offs that differ between individual patients.
Breast reduction is often possible with shorter scars
Most often in our practice we use a short scar technique in breast reduction and this procedure may work well for your breast reduction. With breast reduction a scar line will be necessary around the nipple. This allows some adjustment of the size of the areola if needed and a lift of the nipple higher up on the breast. After reducing the breast the excess skin is trimmed vertically down to the fold under the breast, what my patients call a "lollipop" scar. The short scar reduction prevents the anchor scar which extends onto the chest or cleavage area, and the scar out on the side of the breast and chest.
Even with an F cup size the short scar reduction may be right for you. Younger patients with better skin elasticity and less droop to the breast particulary do well with this technique.
Another advantage of short scar reduction is the more rapid recovery, usually about a week, and the ability to complete breast reduction without a hospital stay. All of our patients go home from the office or the surgical facility the same day.
Of course your personal healing and skin type will determine the eventual scar quality but we believe less is more.
Best of luck,
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.