Can my hypertrophic scarring be improved? (Photo)

Question

I had a breast reduction in March of 2014, a little over a year ago. I immediately noticed that my scars were thick and ugly. I was told that they looked normal and would decrease over the next year by my surgeon. As you can see, I still have very significantly thick scars, numbness in one nipple and breast, and partial numbness under my arms. I don't expect sensation to come back, but can my scars be improved? What caused this?

Jed H. Horowitz, MD, FACS · Answer

I have
my patients use a #scar cream such as Biocorneum to allow the scars to fade as
much as possible.On occasion, we may
recommend laser treatments to improve the #healing.

Edwin C. Pound, III, MD · Answer

It takes about a year to a year and a half for scars to fully flatten, fade, and mature.  Since your surgery was over a year ago, I doubt that there is a whole lot that you can do conservatively with them at this time.  There are a number of scar creams that are currently in use.  The fact that there are so many available lets you know that none of them is perfect or else we would all be using it.  If you wanted to use any of those scar creams, it would have been better to have started while the scar was still "young."  Another option would be to inject steroids into the scar but, again, it would have been better to have done this earlier.  At this point, you may need to have the scars excised (cut out) and re-sutured.  This could probably be done under local anesthesia in an office setting.  Once the revision has been done, then the various conservative scar treatments will be more effective.

James D. Frost, MD · Answer

Cesiley,Hypertrophic scars are very common after breast reduction.  You correctly use the term "hypertrophic" rather than "keloid".  A keloid scar generally keeps getting worse with time as compared to your hypertrophic scar which tends to gradually improve.Although a year may seem like an eternity, it is not that long for the healing process.  It may take 2 or 3 years to see the final results of the healing process.I have not been impressed by the results of silicone patches, silicone gels or other topical treatment when used on a year old scar but I do recommend them after scar revisions.If you can wait, I would give it at least 2 years before considering revision.  If you feel you must do something now, speak with your surgeon about revision.  Insurance generally does not cover scar revisions so expect there will be some cost involved.Good Luck

Jeffrey Claiborne, MD · Answer

After a year, thick and wide scars usually do not change dramatically. They may flatten a little bit more but usually not too much. Sometimes steroid injections can help flatten raised scars. You can get a scar revision which can change a wide scar into the thinner, prettier scar. Lasers can help with red pigment in scars if that is a problem. Hope this helps.

Josef Hadeed, MD, FACS · Answer

Generally speaking, scars can be revised to improve the appearance.  Scarring is, unfortunately, unpredictable in regards to what the final appearance will be.  A consultation with a board certified plastic surgeon can help you to understand what your options are.  Best wishes.

Andrew T. Cohen, MD, FACS · Answer

Some patients heal with a keloid scar.  I have taken care of many patients with this by doing a scar revision and then using Embrace post op to get a better looking scar.  embrace is silicone sheeting that takes the tension off the scar as it is healing.  Look for a Board Certified Plastic Surgeon. Good Luck,Andrew Cohen MD

Can my hypertrophic scarring be improved? (Photo)

Answers (6)

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