Risk of Pink Scarring After Breast Lift and Augmentation?

Opinion needed on getting a breast augmentation, and a possible lift. I have had four children, and I am 27 years old, 5'5", 125 lbs. I am very light-skinned, and I scar really badly so I am worried about scarring that will be pink, and very obvious on my skin tone. I want to look as natural as I can when I’m completely naked. I have added photos of my breast and upper body for a visual on exactly what my breast look like now. So lift or no lift? Augmentation, or not? Also any opinions on the Endoscopic-Assisted Breast Augmentation?

Doctor Answers 27

Breast augmentation without breast lift may be possible

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Thank you for your question. If you simply want your breasts Fuller a breast augmentation alone without a breast lift may certainly be possible. Please consult your board certified plastic surgeon and specifically asked if this is possible and your case.

If you do choose to have a lift I would reassure you that most patients find that scarring white natural color at 1 year and are very happy with the new shape of their breasts.

Decision-making in breast surgery

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What is it about your breasts that you do not like? What is it that you want? While artists and plastic surgeons have certain concepts about the ideal or perfect breast, it does not necessarily apply to each patient. Patients, and doctors, can be hyper-critical of breasts. Your breasts, by all normal parameters, are normal breasts. There are not screaming for surgery. However, what you desire will determine the treatment necessary to get you there. Once the path is outlined, you'll have to ask yourself if it is worth it. These are individual issues that cannot be answered with one glance at a photo.

Robin T.W. Yuan, MD
Beverly Hills Plastic Surgeon

Pink Scars after breast lift and augmentation

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All scars are initially pink from the inflammation which occurs during wound healing. As scars mature they fade to a silvery white appearance. Thickening or spreading of scars can sometimes occur due to a variety of reasons but this is usually not the norm.

My recommendation is to go with a large enough implant to fill out your skin yet still be compatible with your tissue requirements, ie. not too big or sagging will occur, and try to avoid putting a scar on your breast as a lift would do.

I would go with a subglandular Gel implant and No Lift. The implant would be placed through an imframmammary approach, in the crease, which will be hidden and well tolerated. No need for endoscopic surgery for this. It would not be worth the additional time under anesthesia or the expense in your case.

Most importantly, find a Board Certified Plastic Surgeon to evaluate you in person.

Paul Rottler, MD
Saint Louis Plastic Surgeon

Breast lift and Augmentation

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Dear Texas,

The discussion needs to start with :"Do you like the current size/volume of your breasts?" - if the answer is YES - then we need to only focus on a breast lift (Mastopexy). IF the answer is NO - then we can discuss augmentation.

In my opinion, although good looking results can be obtained with other incisions - the periareolar breast augmentation incision is in many cases, including yours, superior to all others. It allows unrivaled visibility of the breast implant pocket (allowing modification on the go), it can be easily converted to a lift (if the breast implants have not lifted the nipple complex high enough) and unlike some of the others, the periareolar scar is re-usable.

If you would like more volume, I would recommend a perihelia approach breast augmentation with a suitable implant with a possible either perihelia breast lift or conversion to a small Lollipop lift, as needed.

I would not worry about the endoscopic approach here since you cannot really have an endoscopic lift NOR would I be overly concerned about scar quality.

Peter A. Aldea, MD
Memphis Plastic Surgeon

Breast augmentation and lift

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In my opinion, you could have a very nice result with a periareolar lift and submuscular augmentation. The lift will elevate the nipple, shrink your areolae which are too large now, and allow access to place the implants. In the end, you should have a very thin scar and it will be between the areolar skin and the normal skin so it wil be more of a boundry than a scar. Please see many photos of this on my web site.

Breast augmentation will give you nice results, but you may need a small lift

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Thanks for submitting the pictures - it makes answering your questions so much easier!

Looking at your pictures, you have ptosis (droopiness) of the breast gland, but not much droopiness of the nipple and areola. Most of this can be corrected with placement of a breast implant, which can add volume to the upper pole of your breast. Without examining the breast skin envelope, it's hard to know if an implant alone will allow the nipple-areola complex to settle in the perfect position. In all likelihood, though, if you need a breast lift, it'd be a relatively minor one, with an incision around the areola (circumareolar) alone.

Transaxillary endoscopic-assisted breast augmentation, in the right patient, can be a great operation. I particularly like the operation with placement of saline implants. In your case, though, because you may need s small lift, I think a better choice of incision would be periareolar (at the junction of pigmented areola and nonpigmented skin). The implant could be placed through this incision, and if your surgeon were to decide intraoperatively that you need a small lift, he or she could easily convert that incision to the one needed for the lift.

So to summarize: implants, yes; lift, maybe; endoscopic augmentation, no (in your particular case).

Best advice is to seek consultation with a board-certified plastic surgeon who can examine you in person. Best of luck.

Breast Augmentation with Lift

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A mastopexy or breast lift operation is designed to improve the shape and position of the breast without reducing their size. It is used for breasts which sag or droop (ptosis). Sagging of the breasts may occur with normal development for some women, or as part of the aging process. Pregnancy, breast-feeding and weight loss are other conditions which increase breast ptosis. Some patients will have a better shape to their breast such as increased superior fullness if an implant is used at the time of mastopexy. The procedure can also be combined with a minor breast reduction to reduce the breast width if desired. The surgery will create an elevated, more youthful breast contour. Also, the procedure will create nipple and areolae of the desired size and at the correct height.

I prefer to use a #shortscar technique, #LollipopScar or #DonutLift” rather than the majority of surgeons in the United States that use an anchor pattern lift which involve more significant scarring.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 116 reviews

Risk of Pink Scarring

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Thank you for the question and photo.  After the breast lift or augmentation, one thing that can't be avoided are scars.  They'll be there whether you like it or not.  Scar treatment and management is crucial after your operation so best to sit down with your board-certified plastic surgeon and discuss possible options which you can use to reduce how the scar looks like. Best of luck. Dr. Michael Omidi.

An in-person exam with a board-certified plastic surgeon is the best way to assess your needs and provide true medical advice.

Michael M. Omidi, MD, FACS
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 121 reviews


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Let me concentrate on your concerns about scarring after your breast surgery. Fortunately there are ways to minimize your scar. Best Scar Management is important to minimize or completely hide from view, the telltale signs of your surgery—namely, scars. Both you and your surgeon want you to have the most minimal scarring possible. There are many possible causes for scars that are enlarged or not healing well. Unsightly scars are most commonly due to genetics, underlying medical conditions, or improper scar/wound care. The last part is very important and patients can make a noticeable difference in their scars’ appearance by following best scar management practices. Here are some simple tips  in the link below.

Scar cream after surgery

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Our office specializes in scar revision, especially for the breast. We utilize a protocol that includes non ablative, ablative, IIT, RF, and topical therapy. We also recommend use of the Plato's Scar Serum after surgery. 


Dr. Karamanoukian 

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
4.8 out of 5 stars 95 reviews

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.