I am an African American 8 months post op (breast aug) and I am very worried about how my scars are healing. They often appear bright pink or red. Also I can feel the scars over my shirt this worries me that they aren’t healing flat enough. I have not used anything to aid in the healing of the scars and wonder if I should use some of the suggested silicone strips, scar cream or vitamin E.
Are my Areola Incision Scars Healing Well? (photo)
Doctor Answers (20)
Areolar Scarring after Breasr Augmentation
You should consider several options which include scar revision with early silicone gel sheeting application as well as cosmetic tattooing of the scars to camouflage them. Tattoos won't make the scar flatter, but should conceal the pink color. Consult with your plastic surgeon to determine which options are best for you.
Are my Areola Incision Scars Healing Well?Answer:
I think after 8 months your scars will not improve much no matter the treatment. On occasion, peri-areolar scars do need to be touched-up and that is usually done as an in office procedure under local anesthesia. I my practice I perform this for my patients free of charge, included as part of their original procedure if needed...
Quality of periareolar scars
Reviewing your photographs shows somewhat widened scars, but more importantly the scars are hypopigmented which makes them stand out even more. I would try some scar management with massage, Mederma, and gel sheeting. I would try to hold out to see if some of these pigmentation issues improve. Most likely, however, you will require a scar revision.
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Unsatisfactory appearance of areolas after breast augmentation
Unfortunately, your scars have not healed well or to a satisfactory degree - and that is why you are seeking answers. It is unlikely at this point in time that there will be a significant improvement in their appearance. My suggestion would be to return to your plastic surgeon (or another) and discuss the possibilities. These can include scar revision with early scar treatment afterwards. Meticulous closure would be necessary otherwise you may see a repeat of this outcome.
Consideration can also be given for tatooing the depigmented areas to make them less noticeable.
Areola scar problem
Thank you for providing photos for review. I think a trial of Cordran tape is worthwhile. Once the scar is soft you may want to consider having a medical aesthetician tattoo the pink areas of the scar to better match the pigment of your areola.
Cortisone is good for thick scars but it may lighten the color of the scar as well
If you have a thick scar 8 months after a breast augmentation it still may go down and soften. If it does not cortisone is an option but it may blanche the scar and make it more visible, also it may thin it out too much as well. This would make the scar indented instead of raised. Silicone gel sheeting is the only proven treatment other than cortisone injection which has been shown to improve scar thickness. If the color of the scar does not improve surgical revision is a good option.
Treatment of breast scars
The photos are helpful, and demonstrate that the primary factor causing visibility of the scars is pigment abnormality. Steroid injections, tattoo, surgical revision, and topical treatments such as NewGel, Cimeosil, Hybrisil, PMT, or other silicone scar reduction products may be helpful in combination.
Peri-Areolar Scars may be quite visible
Placing breast implants through a peri-areolar incision (around the areola) is my least favorite approach for breast augmentation. This is because the scar can be very visible. If it doesn't heal perfectly, it can look wide, thick, light, or dark...and is tough to hide. I prefer placing the scar in the breast fold because even if it heals poorly, it is more easily hidden in the crease and is not right in the middle of your breast. If the scar is thickened, steroid injections and topical treatments with Kelo-cote may help. A scar revision may also help but if your body is "programmed" to make a bad scar, the new scar may be the same or even worse. For light scars, tattooing is often a good option to help camoflauge it.
Your scar is definitely a little thicker than one would like, but unfortunately you are not guaranteed that the problem will not occur again with scar revision. You may want to ask you PS to prescribe Corduran tape to wear on the scars for a few months, we have had excellent results with this approach.
Hypopigmentation is a difficult problem
Thanks for your question. You have hypopigmentation of your scar (too little pigment/coloration). You may gain pigment still for the next several months which will fill in the light spots. I do not know of any topical products which will improve that process. Silicone sheeting is excellent for keeping your scar flatter. If after 18 months you still have light areas you may have to consider a scar revision if it still troubles you.