Can These Breast Reduction Scars Be Repaired? (photo)

Hello ATX Girl,

Drs. Marosan and Becker represent either end of the spectrum on how to fix your problem.  Dr. Becker is focused on the raised, hypertrophic periareolar scars and a minimal surgery to fix them.  Dr. Marosan looks at the situation in a more global view; that the etiology of the scars are from excessive tension, that your breasts are still wanting in shape and lift, and that reducing and re-lifting will give you scar improvement and much more. 

My personal view is the same as Dr. Marosan.  Most importantly, if you simply cut out the scars without addressing the persistent weight and forces on those scars, there is a higher likelihood of recurrent scar thickening.  By reducing the size of the breast more, and redistributing the forces towards new vertical and inframammary scars with a revision lift, you are more likely to get fine white scars.  You would be surprised how many inches of skin can be removed from the bottom of your breasts!

Dr. Jennifer Walden is in your area, and she trained in New York at a fine program. I don't know her personally, but you should visit and look at her pictures.

Best of luck!

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

The brief answer from your photos is yes, a scar revision woulld most likely help you minimize your scars.Here are some other guidelines to help you: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.Scar Management tips:Minimize tension on the scar. Steri-Strips and/or surgical tape are often placed in non-hair bearing areas to minimize tension and keep pressure over the scar. This minimizes the stress that can pull the scar apart (dehiscence) creating a wound and delaying healing time, and can make the scar wider, or more “ropy”.Keep your incision site/scar clean to prevent infection. Follow your surgeon’s wound care instructions to the letter with out modification. Never apply different products then recommended without first discussing them with your surgeon. This is especially important during the first few weeks. If there are any signs of infection, contact your surgeon’s office right away and/or see your doctor or his nurse immediately. Typical signs of infection may include redness outside the immediate incision site, asymmetric swelling, and drainage, of pus, fever, chills, and “feeling sick”.Protect your scars from the sun. Staying out of the sun is the best advice. Minimal exposure to sunlight is prevents hyperpigmentation (permanently turning brown) and other problems that can make the scar more noticeable. Sunscreen, at least 30 SPF and an overlying make camouflage make up additionally protects the scar from the suns harmful rays. This advice is especially important the first year following your surgery.Use specific scar maturation products recommended by your surgeon. Patients seem to have their own opinions on this touting everything from Pure Vit E, Coco butter, to Aloe Vera, etc but most have minimal benefit other than keeping the scar hydrated. Although hydration is important there are better, scientifically studied products with greater efficacy. Most of the scientific articles written about this subject indicate that topical silicone gel or silicone sheets work the best. There are a lot of products to choose from, but silicone should be one of the key ingredients. Although Mederma, an onion extract derivative active ingredient rather than mainly silicone based may help, primarily silicone based products are better and many also contain other ingredients that may be synergistic (hydrocortisone or other steroid, Vitamin E, Sunscreen,etc). At the present time I prefer BioCorneum or Kelo-Cote products especially on areas that silicone strips aren’t applicable, for example, on the face. If the reader has problems obtaining these they can call my office. Patient compliance is also critical – use often and according to directions or it will not work optimally. NEVER apply products without first discussing them with your surgeon.Monitor to make sure your scar is progressing optimally. Keep your scheduled follow-up appointments with your surgeon to verify that your scars are maturing as expected. Occasionally if indicated you may need a topical steroid preparation or even a series of injections (5-FU and/or Steroids) or laser treatments to treat or prevent scar hypertrophy or keloid formation (red raised scars), or other topical medicines to treat post inflammatory hyperpigmentation (brown scars) with prescription creams and possible laser treatments.

The scars can be revised, and you will probably get a much better result. 

Good luck.

Thanks for your question and your photos. It is difficult to comment on your shape without having a preop picture or knowing the technique that was used. I do think that your scars could be improved upon. Sometimes this occurs when the original areola is very wide and the desire is to decrease it. I usually use a barbed suture in this scenario to try and maintain the tension circumferentially. You did not specifically comment on the shape, but if you wanted less fullness inferiorly then a wedge could be excised. I hope you are able to find someone that you have confidence in. Best of Luck!

Thank you for your question and photos. Without the benefit of a preoperative photo, it is hard to comment on the results. I see that you have thick scars and widened areolae. You have asymmetric breasts which are saggy. I personally would suggest a breast lift/small reduction to give you better shaped breasts with smaller areolae in the appropriate position. Your scars are wide and thick because at the original closure there was a lot of tension on the suture line. See a board certified plastic surgeon with experience in secondary breast suergery. Good luck.

Thank you for the question and pictures.

Yes, scar revision surgery may be very helpful in your case. If you also have concerns about breast size and/or position on the chest wall, additional surgery may be helpful to improve shape/size of the breasts as well.

 Best wishes.

Yes you can think about a scar revision. But you could be a scar former so be prepared for the return of these scars. 

Short answer is yes.  Given that the shape is somewhat irregular a revision is in order.  This would essentially mean removing some skin and a bit of areola.  It can be done under local anesthesia. 

The only thing is that with the raised scars, this may occur again.  During the post op period, have ps monitor scar so intervention can be started early.

 

You are not disfigured, even though you feel that way, and the treatment isn't that bad.

It is difficult to see the vertical part of the scar in the photos but I think the important issue is what disturbs you about the breasts. From your question, it sounds like the shape and scaring of the nipple areolar complex is the main problem. While a revisional reduction/lift would address the global problem, this may not be a financial reality for you and your insurance may deem this to be cosmetic. In that case, a more limited procedure may be well worth consideration.