I’m having a breast reduction in a month and am slightly worried about keloids - I haven’t gotten any before, but I also haven’t had surgery before. There's no history of keloids in my family. I do have super sensitive skin though and had some small scarring when my ears were pierced (the scars went away in a year though). I’ve gotten a very small tattoo in my bra area and it healed fine - could this mean there’s a smaller chance I’ll keloid/get hypertrophic scarring from a breast reduction?
Risk of Keloids/hypertrophic Scarring from Breast Reduction?
Doctor Answers 5
Scarring after Breast Reduction
If you have not "Keloided" by now, you should not do so. A Keloid is a problem that occurs in certain people with a genetic tendency to do so. With what you have had, you should have done so if you were going to. A hypertrophic scar, on the other hand, can happen to anyone. It is most frequent when fast absorbing sutures are used below the skin and skin sutures are removed soon after surgery. When more permanent sutures that maintain their integrity for a number of months are used below the skin as the only sutures used, the risk of hypertrophic scarring decreases to negligible. In breast reduction, I also remove the surface of the skin leaving the thicker dermis as reinforcement to support the scar and further reduce the risk of a bad scar. Ask your surgeon what he/she does to reduce the chance you will have an unattractive scar after the procedure and look at pictures of the postoperative results.
Keloids/Hypertrophic Scarring from Breast Reduction
It is often difficult to determine preoperatively who will have keloid or hypertrophic scars following breast reduction. Keloid scars and hypertrophic scars are two different issues. Keloid scars are the result of an abnormal scar response in which the scar expands outside of the area of injury.and then does not regress spontaneously. Keloids will tend to recur after excision. Hypertrophic scars are red and raised, but do not expand outside of the area of injury.
The occurence of a keloid scar has a genetic component - people who have family members with keloid scars have an increased chance of healing with a keloid scar. In my experience some patients will form keloid scars in some area of their bodies, but not others. In some patients closing a surgical wound with meticulous technique will still result in a keloid scar.
Hypertrophic scars are not thought to have a genetic component and are likely to improve with excision and reclosure. Proper surgical technique with a tension free closure minimizes the risk of hypertrophic scar.
Keloidal or hypertrophic scarring
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Keloiding after breast reduction
Most people over the age of 20 know whether or not they are prone to keloids. Regardless of having prior surgery, people who keloid can form these tumors from a fall, cut, peircing, or tattoo. So it is in your favor that this has not happened to you. I would discuss your concerns with your plastic surgeon but in most cases the breasts heal very nicely. I hope this helps you.
Neil J. Zemmel
Hypertrophic or Keloid Scarring Breast Reduction
History is very important regarding chances of keloid scarring but is not the only factor. Anyone may form hypertrophic or keloid scarring. The goal is to minimize the risk. That involves patient selection, good surgical technique and good post operative care. Discuss this with your surgeon.