Can Scarred Tissue Under Breasts Be Removed During Breast Augmentation?

I have HS (hidranitis suppurtiva), which is a skin disease with no cure or treatment. I have a lot of scars under one of my breasts. The scars start from the bottom of my areola to below the crease of my breast. Can the surgeon remove all of that scarred tissue under my breast during breast augmentation? My breasts are also of different sizes (large A cup and large C cup). I just want normal, SAME SIZED breast. I would like to have my breast implants inserted through the nipple and under my muscle. Please help!  Thank you so much!

Doctor Answers 11

Scars can't be removed with breast augmentation

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Unfortunately, breast augmentation does not remove any breast tissue, therefore the scars will remain under your breast after surgery. Please see an experienced board certified plastic surgeon for a physical examination to determine which treatment would be best for you, and whether periareolar sub muscular breast augmentation is suitable for you.

Breast implants should never be placed through an infected area

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If you have HS then you have a chronic infection and this is a major problem if you want to have breast augmentation. HS needs to be treated first before you should consider implants otherwise you are at high risk of an infection or at best severe capsular contracture of your breast implants.

Martin Jugenburg, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 521 reviews

Breast implant augmentation in patients with hidradenitis or open wounds (photo)

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The picture above shows what appears to be active wounds which may contain bacteria that could increase the risk of complications following breast implant augmentation surgery. I would be reluctant to consider surgery in this instance without looking further into the disease state.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

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Breast Augmentation and hidradenitis

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Hidradenitis is a chronic and at best irritating problem. I pose that it could be a real detriment to breast augmentation. The reason is that there is a real danger of serious breast cellulitis, when the implant is in place, if you get a flare up of the hidradenitis.

Regardless, if you wish to proceed there is no cosmetically appealing way to remove all of the skin of the lower pole of the breast. Excision of the skin and skin grafting will remove this tissue but the scar from the graft would be unacceptable. Otherwise there aren't many alternatives.

Hidradenitis and breast augmentation

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Infection and brest implants do not mix. I would treat the hidradenitis first.  Then I would reassess in a few months to make sure no disease process returns before performing a breats augmentation.

Steven Wallach, MD
New York Plastic Surgeon
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Hidradenitis and Breast Augmentation

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This is not a good idea. As these areas harbor bacteria you should not have implants placed while you have these lesions.

What it does appear like is that you probably need a lift. I would choose to have the breast lift done on you, probably an anchor or "T" lift which would remove a good deal of this if not all.

Let things heal and then in about 6 months you could venture down the path of breast implants.

Good luck.

Farbod Esmailian, MD
Orange County Plastic Surgeon
5.0 out of 5 stars 88 reviews

Hidradentitis and breast augmentation

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You have 2 problems whose solutions should not be combined. I would recommend dealing with the hidradenitis first. You really should have that under strict control and not anticipate any additional surgery before proceeding with a breast augmentation. You may find that with the amount of skin that needs to be removed due to the scarring the breast implant size may change. Only after you have healed completely from the hidradenitis surgery should you decid upon the augmentation surgery.

John P. Stratis, MD
Harrisburg Plastic Surgeon
4.5 out of 5 stars 37 reviews

Breast Augmentation with Hidradenitis

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I certainly would not remove the scars from your HS during a breast augmentation. In fact I would be concerned about placing an implant in your situation at all. You are at a much higher risk for infection of your implant. I think you should consider an analagous tissue transfer which might even be a civered benefit with your HS and significant breast asymmetry.

John Whitt, MD (retired)
Louisville Plastic Surgeon

Hidradenitis Suppurativa and Breast Augmentation

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Dear Leslie,

After reviewing your question, I would recommend two (2) separate operations. The first, the surgical treatment of the hidradenitis of the infra-mammary fold. Than after 2 to 3 months have the augmentation through a separate incision like the circum-areolar or axillary.

Hope this gives you a plan.

Hidradenitis Suppurativa and breast Augmentation

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"I have HS (hidranitis suppurtiva), which is a skin disease with no cure or treatment. I have a lot of scars under one of my breasts. The scars start from the bottom of my areola to below the crease of my breast. Can the surgeon remove all of that scarred tissue under my breast during breast augmentation?"

Hidradenitis Suppurativa MAY be curable early on with aggressive antibiotic therapy but once it becomes established the only solution is surgical - the removal of all scar and tunnels containing pus and allowing the area to recover. What may be required in your case is not so much breast augmentation but removal of the process and breast reconstruction.

If indeed that is what you have, I would NOT perform a breast augmentation on you the same time for several reasons: first, the amount of diseases tissue removed will decrease the size of the breast. Second, the area will be contaminated and any implant placed at the same time is very likely to become contaminated.

Charlotte has one large group of Plastic surgeons and many other excellent plastic surgeons as well. Consult with several of them before you decide.

Good Luck.

Peter A. Aldea, MD
Memphis Plastic Surgeon

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.