Breast reduction scars after surgery. Any advice? (photos)

Question

I had a breast reduction last year in March. My incisions never healed correctly now my scars look horrible. I've tried steroids shots but it didn't work. So now I'm thinking about getting them cut off. However I'm worried that they will return. Any advice?

Jed H. Horowitz, MD, FACS · Answer

Every woman who has breast reduction surgery, finds herself dealing with scar tissue or keloids after her wounds have healed. It appears from your pictures, you have keloids.
 Scars are caused when the dermis, the layer of skin underneath the surface, is damaged. The body produces a fibrous tissue called collagen to close the wound and assist in healing. When collagen is left behind once the damage to the dermis has been repaired, a scar is the result. The extent of an individual’s surgical scars has much to do with genetics, age, the type of surgery. No two surgeries are identical and neither are the outcomes. Although most scars will fade and diminish over time, keloids tend to not. Prevention is the key. However, if you have a history of keloid scaring on others parts of your body, then this can be far more difficult. No one treatment for keloids is best. If steroid injects didn't work, I would suggest following up with the surgeon that performed your reduction surgery to discuss you options and any addition procedures. Good luck!#plastic surgery #breast reduction #Keloids #incision scars

Raffy Karamanoukian, MD, FACS · Answer

Plastic surgery scars require attention after surgery so that they remain cosmetically-appealing and barely noticeable. In our office, we use a protocol for scars that minimizes their activity in the 6-8 weeks after surgery. If you have late plastic surgery scars, you may also require laser and RF therapy to help reduce the longterm effects of the scarring. Keloids, hypertrophic scars, widened scars, red scars, and hyperpigmented scars all require scar modulation with topical creams followed by lasers and RF therapy. Topical skincare should be directed to a specific need, whether for pigmentation or hypertrophy and our office can guide you through the process to obtain the correct Plato’s Scar cream or Melarase cream for hypertrophy and discoloration. In terms of lasers, we would employ the vbeam laser for redness, Venus Viva RF, PRP microneedling, chemical peels, and Morpheus 8, fractional erbium, or fractional co2. All of these have their individual benefits. Most of all, we recommend you visit a solid plastic surgeon who understands surgical scar revision, laser therapy, and RF therapy for scars. 
 
Best, 
Dr. Karamanoukian
Realself100 Surgeon

Earl Stephenson, Jr., MD, DDS, MBA · Answer

Thank you for your pictures.  You definitely have keloids.  A combination treatment of surgery, steroids, 5FU may be necessary.  Consult with several board certified plastic surgeons.

Darryl J. Blinski, MD · Answer

History of Keloids? Best to seek only in person evaluations. Laser therapy, radiation therapy, scar revision or combination of all these options.....

Alan M. Engler, MD, FACS (retired) · Answer

Scarring is a part of all surgery, and certainly a breast lift or reduction. As in your case, incisions (and scars) are often an anchor-patter, extending around the areola, down to the IM crease and then across in that crease.At your point in the healing - nearly a year - it is reasonable to consider a scar revision.  You would of course need to discuss this in person with your own or another board-certified plastic surgeon, but it does look like you would be a candidate for an attempt to make them look better.  I put it that way because there is no guarantee that the new scars will be better than the old.  Then could be the same or even (though rarely) worse.  But if you had healing problems the first time around, then redoing them now under hopefully somewhat less tension may provide a better result.I hope that this helps and good luck,Dr. Alan EnglerMember of #RealSelf100

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