I had a breast reduction about 2.5 years ago, when I was 17 years old. I unfortunately developed keloid scarring. I was wondering what the best way is to go about treating them. I've had some laser treatments and that definitely helped but they were very painful. I am considering kenalog injections and then possibly, when they have flattened, some cosmetic tattooing. Are these good ideas?
What Are the Best Treatments for Keloid Scars After Breast Reduction?
Doctor Answers (8)
Breast reduction scars and improving scars on the breast
I would begin treatment for your breast scar keloids with pulsed dye laser and judicious IIT therapy. These scars will improve.
Silicone tape, steroids injections, then scar revision. See a Board Certified Plastic Surgeon for this. Thank you for your question and good luck with everything.
Web reference: http://www.elitemdspa.info/
Hypertrophic breast reduction scars
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Hypertrophic scars following breast reduction in a 17 year old
As you have read from the other plastic surgeon respondents, the scars that you have are hypertrophic ones rather than keloids. This is relatively good news as hypertrophic scars are more easily treated as compared to keloids which can be quite difficult to eradicate.
At your age, hypertrophic scars are not uncommon with breast reduction surgery. Given you photos and history, my recommendation would be to surgically remove the thicker and wider areas, meticulously repair the wounds with longer acting dissolvable sutures, inject them with a very low dose steroid, protect them for a few weeks with surgical tapes and them start with silicone gel sheeting for at least several months. Certain physical activities that could exert distracting forces on the wounds (pulling apart) should be avoided.
Web reference: http://www.turkeltaub.com
Hypertrophic Scars Following Breast Reduction
You have hypertrophic breast scars, not keloid scars. These do seem to occur more commonly in younger patients, and the alignment of the skin edges, wound tension, and suture material used may also play a role. It appears that some areas have improved after your laser treatments and are now flatter, but remain widened. Additional laser treatments and steroid injections may help to soften and flatten the residual areas of hypertrophy. You will be left with wide scars following these procedures, and they may have a pink coloration. Sometimes additional IPL or laser treatments can lighten this pink color.
If your goal is to try to remove as much of this scarring as possible then you will need to consider surgical scar excision. The subsequent healing may be improved since this revision will likely involve less tension across the skin closure, and care can be taken to realign the skin edges well. Post-op taping and silicone gel sheeting may provide some additional benefits. When it comes to scar revisions, there are no guarantees that unsatisfactory scarring won’t occur, but I suspect that you will have a better result.
I would not recommend cosmetic tattooing of these scars. The thin scars may not take the pigment well, and more importantly it is impossible to match the skin coloration well with tattoo pigments. Skin coloration constantly changes and there is not a good way to match this with (even multiple) tattoo pigments that will always be the same color.
Best wishes, Kenneth Dembny MD
Options for hypertrophic scars after breast reduction
Hopefully better options will be available in the future, but you have had the standard treatments with laser and steroid injection. Check out clinicaltrials.gov and search hypertrphic breast scars.
Best Treatments for Keloid Ssars After Breast Reduction?
Good News and Bad News.
You do NOT have Keloid scar (raised scars which overflow the margins of the original injury or surgical incision). These are MUCH harder to treat successfully.
Instead, you have a mix of widened (? result of Kenalog shots) and Hypertrophic (exaggerated, speed bump like) scars. Many of these can be made to look better by surgical excision, revision and meticulous closure with dissolving stitches in multiple layers minimizing tension at the skin surface. Additional treatment with scar modification (Silicone sheeting, Mederma, Vit E ) may also help the final appearance.
Dr. Peter A Aldea
Keloid and Hypertrophic Scar treatment
Your scars are more accurately termed hypertrophic scars rather than keloids, although I doubt that distinction brings you any comfort! Many young breast reduction patients develop scars such as these. If you did not use silicone dressings during the healing process, you could consider excising the scar in the inframammary fold and keeping silicone on it during the healing process. If that worked well, you could try the same on the rest of your incisions. Steroid or fluorouracil injections could be tested in bad areas, and if they work well you could try similarly treating the rest of your scars
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.
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