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Risk of Scarring from a Breast Lift with a History of Keloids?

I am interested in having a breast lift. Currently I'm a 34DD, and happy with the fullness and amount of breast tissue that I have. I don't feel that I'd need an implant but I'm unhappy with the my chest's "droopy" look when I remove my bra. If I undergo this procedure, what are the risks of serious scarring or keloid development? I've had a history of keloids on my ear that were successfully removed with steroids and surgery as well a hyperthropic scar on my knee. Would this affect my chances? If so, what can be done to minimize it? Also, what would be the average costs of these procedures in major cities such as NYC or LA?

Doctor Answers 21

Keloids are unpredictable: Consult an experienced Plastic Surgeon

The develepment of keloids are very unpredictable. I'll give you an example. Suppose a patient sustains two identical injuries, one on the left arm and one on right arm. A keloid may develop on one arm, both arms, or neither arm. Its totally unpredictable.

If you have a history of keloid scars, there is a higher chance that you will develop them on your breasts after surgery.

Typically, an experienced surgeon would advise you against performing elective surgery as the risk of poor scars is higher in someone with your history.

Keloids are quite difficult to treat. You should seriously discuss these issues with your plastic surgeon and weigh the benefits of breast lift (mastopexy) vs. poor scars.

Finally, the goal of a breast lift without implants is to improve the appearance of your breasts in the nude, not in clothes. If you feel that you would be accepting of a breast scar that may be noticeable in the nude, then you may discuss breast lifting with your surgeon.

Los Angeles Plastic Surgeon
5.0 out of 5 stars 70 reviews

804 7th Street
Santa Monica, CA 90403

Preventing Keloids and Breast Lift

If you have had a previous history of keloid formation, you are at risk for forming keloids with any cut, whether from surgery or trauma.

There are a number of treatments that can be very helpful in preventing the development of keloids.

Atypical preventive treatment uses steroid injections into the scar, or the application of steroid cream or tape to the scar surface.

Breast lift will certainly involve scars, one of the tradeoffs of the procedure.

Carefully discuss those tradeoffs with your surgeon and a plan for keloid management before surgery.

Paul C. Zwiebel, MD
Denver Plastic Surgeon
4.0 out of 5 stars 17 reviews

2050 E County Line Rd
Highlands Ranch, CO 80126

It is hard to avoid keloids

Your surgery will be a higher risk for keloid scars since you had some of these before. It is a hard decision for you, your surgeon can not prevent the development of the keloid. It will help to avoid a large implant or any tension on the wound. Best of luck!

Hisham Seify, MD, PhD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 17 reviews

20301 SW Birch St
Newport Beach, CA 92660

Keloid scarring with breast surgery

While keloids remain a bit of a mystery, some things are clear.

There are some areas of the body that are more prone to keloids and hypertrophic scars than others. One of these areas includes the central chest.

People with a strong history (personal or family) are at a higher risk of keloiding.

Meticulous technique, silicone sheeting and steroids can reduce the risks of keloiding.

In my San Francisco area practice, people who have a strong history of keloiding are cautioned that even with the best technique and technology keloiding can occur and may require additional treatment. I have not had this happen in the over 400 breast reductions I have performed but it is certainly possible.

In terms of costs, a breast lift without augmentation typically costs about $5000 in my practice.

I hope this helps!

Steven H. Williams, MD
San Francisco Plastic Surgeon
5.0 out of 5 stars 37 reviews

4000 Dublin Blvd
Dublin, CA 94568

There is always a risk of bad scarring with any surgery,...

There is always a risk of bad scarring with any surgery, even on the breast. Having a history of keloids or hypertrophic scarring will increase your risk compared to other women having the same procedure who have not had a history of keloids.

There are, however, some things that can be done to minimize your risk, and these should be discussed with your surgeon in advance:

Using silicone sheet therapy after the procedure (this looks essentially like a large band-aid for all of the incisions, stays on day and night except for showering for a minimum of 6 weeks, doesn't hurt, but seems to help scars soften and flatten)

Steroid injections after surgery, even if the scars look reasonable, as a prophylatic measure.

In the end, you will need to ask yourself if you are willing to trade the risk of bad scars for a better shape to your breast-- if the answer is yes, then a breast lift is an option. Otherwise, be cautious.

Hope that helps,

Dr. S

Shahram Salemy, MD, FACS
Seattle Plastic Surgeon
5.0 out of 5 stars 122 reviews

1101 Madison Street
Seattle, WA 98104

Increased Risk

If you have a history of forming keloids then your chances of forming keloids following a breast lift or reduction are high.

  • Use of silicone gel patches for several months as a precaution
  • Injections of low dose cortisone as soon as problems are detected

These measures may minimize your scars but will not prevent them.

Ivan Thomas, MD (retired)
Los Angeles Plastic Surgeon
4.5 out of 5 stars 13 reviews

1629 West Ave. J
Lancaster , CA 93534

Ear and knee keloids don't necessarily mean breast lift keloids

As others have correctly stated, a history of keloids COULD be predictive of bad scarring following breast lift. You are wise to be cautious, and my colleagues' recommendations are similar to what I would tell you.

BUT, there is a possibility that an ear keloid and knee keloid are not accurate predictors of breast keloids. Other than individual genetic predisposition to form excessive collagen deposition in healing tissues (in the form of hypertrophic scars, or even more aggressive keloids), irritation, inflammation, and repetitive motion can stimulate the production of thicker, unsightly hypertrophic or keloid scars. The ear pierce that is irritated or inflamed (often by allergic reaction to some metals, or superficial infection) can develop a keloid even in an individual that won't develop keloids elsewhere. The same goes for the knee area, which can thicken, widen, or form a keloid because of the constant skin and scar stretch and unstretch with this active area.

Thus, it is POSSIBLE, though in no way guaranteed, that you could have very nice scars on your breasts because this area won't have the irritation and inflammation of an ear pierce, or the movement and skin stretching of the knee area. If you have had a mole or cyst on your chest or breasts removed, or a breast biopsy scar, scarring in these sites would be much more predictive of what to expect with a breast lift. If you have not had any incisions to heal on your breasts, keloids are indeed possible, but not necessarily a foregone conclusion. You need to weigh the potential improvement in breast appearance with the possibility of bad scars, and you should select a plastic surgeon who is just a bit obsessive with his or her suture technique. Good luck!

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
5.0 out of 5 stars 186 reviews

4825 Olson Memorial Highway
Minneapolis, MN 55422

Breast lift and keloid scars

If you have a history of keloids you will be at a higher risk of developing keloids or hypertrophic (thick) scars with a breast lift (mastopexy).  Breast skin however, because it is thinner than skin in other areas of the body, is not as likely to develop keloids.  The type of breast lift you need will also be a factor.  If you need an anchor-type incision which has a horizontal incision in the breast crease, this area is more likely to keloid.  The vertical incision is less likely to do so.  There are some good silicone gels and tapes that you can use to minimize your scarring.  Also steroid injections can sometimes be helpful at controlling your final scar.

Please consult with a board certified plastic surgeon for more information and for a complete exam.

Best wishes,

Dr. Bruno

William Bruno, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 226 reviews

9201 Sunset Boulevard
West Hollywood, CA 90069

Keloids and Breast Lift

If you have a history of Keloids, then your chance of having additional keloids after surgery is greater.  However, you need to make sure that you really have keloids.  Often patient have poorly healed incisions or hypertrophic scars which they think are keloids, but really they are not.  You can talk with your surgeon about options to help minimize the chance of keloids or the limited treatments available if they form.  Good luck with your procedure.  

David Shafer, MD
New York Plastic Surgeon
5.0 out of 5 stars 64 reviews

10 East 53rd Street
New York, NY 10022

Scarring after a breast lift

Your chances of developing a keloid after breast lift is likely higher if your ear scar was truly a keloid scar.  Hypertrophic scars (thick and raised scars) can sometimes be mistaken for keloid scars and they do not have the same genetic basis.  If you are prone to worse scarring, discuss this fact thoroughly with your plastic surgeon.  Look at pictures of patients after breast lifts and understand where the scars will be located.  You have to be comfortable with the risk of potentially having poor scarring after surgery.  There are potential techniques that can help decrease scarring such as minimizing tension of closure, use of silicone sheeting, paper tape application, steroid injection, etc.  But again, you have to be comfortable before undergoing any elective surgery such as a breast lift.

Naveen Setty, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 44 reviews

175 Ridge Road
McKinney, TX 75070

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.