Thick Scars after Breast Reduction, is this normal? (photos)

Question

I have developed these scars after breast reduction. It has been 5 months. Is this type of scarring normal? Surgeon has been dismissive about them. They are also extremely painful to the point I cannot stand clothing against them.

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

Samuel Beran, MD · Answer

As you know, scarring is expected after surgery, but your scars are thicker and more pronounced than most women's.  Usually in a case like this, we begin with steroid injection into the scar and aggressive external scar treatments.  If that doesn't work, the only approach may be excision.   Unfortunately, the same genetics that caused the thickening the first surgery may result in the same with a second surgery.

Robert Cohen, MD · Answer

Your scars are definitely thicker and more discolored than average.  This almost certainly has more to do with your genetics than the surgical technique, but given your current situation, your surgeon should help you minimize the scars as much as possible.  I would consider steroid injections (usually 3 treatments based 6-8 weeks apart), as well as silicone sheeting or a topical silicone product like Biocorneum. Scar massage and UV avoidance is helpful too.  There may be a local scar / keloid treatment center that you could look into too if needed. If you don't get improvement, scar revision at some point with more aggressive early scar care may be necessary. Scars tend to improve over time so better to start with non-surgical options first. Good luck!

Matthew H. Steele, MD · Answer

Thank you for your question and photos.  I am sorry to hear about your scars.  They are definitely thicker and redder than normal at 5 months.  Unfortunately you have developed a hypertrophic scar.  These can occur in some cases when the incisions are too tight or due to your genetics.  At this point, your surgeon may recommend scar massage, silicone therapy, and steroid injections.  If you do not see improvement by 8-12 months after surgery, the only other option would be a scar revision surgery.  Good luck.

Richard P. Rand, MD, FACS (retired) · Answer

Your scars are worse than most and are "hypertrophic" and bordering on "keloid." The crease scar also is not located in the crease unfortunately. You can have steroids injected in them to help.

Thick Scars after Breast Reduction, is this normal? (photos)

Answers (5)

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