Now that it is pretty much evitable that I will need a lift, wondering what is the best plan of action. I have a history of skin that keloids....from my ears, legs & other areas mostly superficial & minor but visible. My concern is having the "lollipop" or anchor lift & forming unsightly scars. Are there any other suggestions?
The Best Lift For Skin That Keloids? (photo)
Doctor Answers 12
Breast lift in skin that keloids
Your concern for keloid scarring definitely sounds significant. You will need strict follow up with your surgeon if you choose to have a breast lift so that if the skin starts to keloid, you can have steroid injections to help. I would seriously consider not having the surgery done as well as the scars might out weigh the benefit in your case. Good luck.
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Breast Lift for Skin that Keloids
Although certainly not mandatory, you may want to consider implants to fill the tissue envelope and improve the fullness. I think that no matter what type of lift is chosen, it will be a variation of a full breast lift or lollipop lift as you mentioned. I would recommend an exam by a plastic surgeon to determine the nature and severity of the previous scars. Find a plastic surgeon who routinely manages patients prone to keloid scars and then Find the plastic surgeon with ELITE credentials who performs hundreds of breast lifts each year. Kenneth Hughes, MD Los Angeles, CA
Anchor lift scar is obsolete, especially in women concerned about scars.
Good question. When it comes to cosmetic surgery, it's always a cost/benefit analysis. Does the benefit justify the cost? And the cost is not just financial but the presence of scars. First of all, you will need not only a breast lift but implants too. Secondly, if you are going to have a breast lift, the vertical lift is the best type. The anchor lift is obsolete in my opinion and especially for you with your concerns about scarring. I'm not sure that you actually are a keloid former based on your description of your scars as "minor but visible." You could opt for implants alone so that you just have a small scar tucked under your breast, but you need a vertical lift to correct your asymmetry (breast implants will not correct this). Your best advice is to look at plenty of before and after photos. I have a rule of 10. You should see ten examples of results from your surgeon that you personally would find acceptable. If you do, the chance that you will be satisfied is high. I've attached a link to this part of my website in case you wish to read more.
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The Best Lift For Skin That Keloids
If you are a keloid former then you may want to have implants only to avoid the possibility of of disfiguring keloids from your surgery. if you do decide to have the lift, please notify your surgeon at the first sign of a keloid so that appropriate steps can be taken to prevent progression.
Keloids after breast lift
It will be important to ensure you have keloids or hypertrophic scarring. If you have keloids any type of breast lift will place you at risk for keloids to develop. Please consult with a plastic surgeon to make the best choice for you.
The Best Lift For Skin That Keloid
I think your best option is to have a consultation with a plastic surgeon. Many patients report a history of keloids that are not keloids at all, and in fact in some are actually normally healed wounds.
If keloids were not an issue, based on the photos a lollipop lift would be suggested, along with implants, Implants alone could be placed through an incision in the breast fold and would be somewhat hidden, but I think there is too much ptosis (sag) and the outcome at least on the left would be unsatisfactory. Based on an exam, it might be possible to compromise with lift involving an incision around the areola only, but that is a compromise and will not provide as much lift as would be ideal.
When you are ready for an in person consultation, RealSelf has listings of surgeons in your area. You should consider cross referencing the listings from the The American Society of Plastic Surgeons (plasticsurgery dot org). A listing in the ASPS website assures you that your surgeon is not only board certified, but also is a member in good standing of the major plastic surgery organization in the U. S. Thank you for your question, best wishes.
Keloids and surgery
A couple of tips here. I hear the words "I keloid" a lot, only to examine the scar and find that is not a true keloid. Keloids are scars that outgrow the original surgical site, become painful, itchy, bulbous, and raised. Keloids are much more common on incisions that are non-surgical where there has been trauma, like an earring hole, burn (you see curling irons a lot) or accidental injury causing an open wound. So, if your keloid is from the above, a nice neat surgical incision usually does not keloid. If you do have a tendency to keloid, the skin can be closed in a low tension manner, placing the stress on the deeper tissues, which helps - also kenalog or other steroid can be injected at the time of surgery. Finally, what most call a keloid is usually a stretched out, wide scar - it's actually the opposite of a keloid. These are common with orthopedic scars that use a stapled closure instead of a more cosmetic layered closure. For you, check with a surgeon to see what your true risks are before proceeding.
Keloid and lift
I think first that you need to be properly evalauted to see if you truly form keloids or hypertrophic scarring. If you truly keloid than you are probably best not to have a lift with the significant risk of having keloid scars.
The Best Lift For Skin That Keloids?
Unfortunately the best lift for skin that keloids is no lift at all, but that is not a very good answer if you are trying to improve the appearance of your breasts. You will need to restore volume with implants, and those scars can hide under your breasts, but it looks like your breasts will hang off of the implants unless you also have a lift. Unfortunately, any type of lift with result in scars around your areola and most probably any lift that gives you a good result will require a vertical scar beneath the areola to the fold under your breast. One question is whether you have true keloids (did you get your ears pierced and did large mushroom-like growths occur on your earlobes?) or hypertrophic scars, and there are treatments (like long term silicone gel taping and injections should the scars start to elevate) that may help, but sometimes those treatments to not prevent the scarring. Ultimately you may have to decide whether it is worth the risk of unsatisfactory scars in order to reshape your breasts.
It sounds like you have a mild propensity to form keloid scars. Actually, as you describe them, it sounds more like you develop hypertrophic scarring as opposed to keloid scarring. Hypertrophic scars, by definition, are thickened scars that remain contained within the scar. Keloid scars, by definition, are much more severe and can grow way beyond the border of the actual scar. Of course, you will need to make the final decision as to the risk of poor scarring and the benefit of the lift. However, I think you should have the following pieces of information when arriving at you decision. Firstly, different parts of the body have different risks of developing bad scarring. Keloid scars, for example, have the highest risk of developing on the ears, mid chest, shoulders, and back. They are almost unheard of on the eyelids. On the actual breast they have the highest risk of developing along the horizontal scar, a bit less on around the areola, and rarely along the vertical incision. Fortunately, there are techniques available that avoid the horizontal incision. You would either require a lift with an incision only around the areola or a lift that requires that incision along with a vertical. Certain breast lift techniques produce better scars than others. Breast lifts that rely on the skin for the lift usually produce poor scarring as opposed to lifts that do not rely on the skin. These latter techniques usually produce very good scars. Finally, what are the options for treatment in the event poor scars develop? Traditional modalities such as creams, silicone sheeting, or steroid injections have some success. They are quite successful in mild hypertrophic scarring, but poor effectiveness in severe keloid scarring. One treatment that is available and has a high degree of success for keloid scars is low dose superficial radiation to the scar area after excision. This modality is a bit controversial as there is concern of risking future malignancy at the radiation site. However, most radiation oncologist believe that the risk is so low that the treatment is justified.
Ary Krau MD FACS