Breast Aug Scars - 4 Months Post-Op

My scars are hypertrophic and unsightly. I am overall pleased with the breast aug but the scars make me feel like I've swapped one set of issues for another. I am using silicone strips but am not satisfied with the results. My surgeon is sort of dismissive about them and just want me to wait it out. Do most surgeons provide kenalog/cortison shots post-op or is it common to have a surgery and then have to find another doc to take care of the scars? Please post suggestions for my scars.

Doctor Answers 16

Surgical scarring and scar widening

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I cannot see why your plastic surgeon would not or could not take care of the scars after surgery. It is part of the surgery aftercare that you paid for when you paid for surgery and within the realm of plastic surgery. Most prospective patients do not seem to understand that when they are doctor shopping. Surgeons that routinely under charge to get a case from competitors will frequently not be able to deliver the required after care because they are forced to move onto the next patient as they have to treat more patients per unit time.

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.

Los Angeles Plastic Surgeon

Laser treatment for scars

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I would consider laser treatment for these scars. In Miami - dermatologist Jill Waibel would be who I would see.

Jason Pozner, MD
Boca Raton Plastic Surgeon
4.7 out of 5 stars 45 reviews

Breast augmentation scar position and tension

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I think your scars are well above the infra-mammary fold, and in that position are subject to significant tension from the underlying implant. I think the measures you have taken so far will improve the scar, but will not change the position. Scar massage is also a very effective means of softening scars. Follow up with your plastic surgeon !

Hypertrophic scars

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The first thing I would recommend is to discuss the scars with your surgeon. There are a number of potential actions. Pressure often with silicone can be used to aid scar maturation and flatten hypertrophic scars.Steroid injection is also a possibility to flatten scars. In general incisions look their worst around one month then slowly mature with time often it can take one year.

Scars from Breast Surgery

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We often treat these cases from plastic surgeons and help remove these scars.  It usually takes a combination of V-Beam and intralesional cortisone injections to help reduce these scars.  Be certain to consult an experienced Dermatologist who treats these types of scars.  Best, Dr. Green

Breast aug scars - 4 months postop

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Hello! Thank you for the question! It is common for scars to fully mature for up to a year. In the meantime, there are a few things that may help to ameliorate your incision/scar. The most proven (as well as cheapest) modality is simple scar massage. Applying pressure and massaging the well-healed scar has been shown to improve the appearance as it breaks up the scar tissue, hopefully producing the finest scar as possible. Other things that have been shown to add some benefit, albeit controversial, are silicone sheets, hydration, and topical steroids. In addition, avoidance of direct sunlight to the incision will significantly help the appearance as they tend to discolor with UV light during the healing process.

If unsightly scars are still present after approximately a year's time, other things that your surgeon may consider are intralesional steroid injections, laser, or just surgical revision of the scar itself.

Hope that this helps! Best wishes!

Scar Removal

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Four months post op is still too soon.  I would suggest waiting at least a year or 10 mo. at the soonest to start interventions.  If the scars are red, you could start treating them with a laser like the v-beam or an IPL if they are very vascular and this can sometimes reduce the redness, possibly some shrinkage as well.  Steroids can be implemented when the surgeon feels the scar is mature enough for that intervention.

Breast augment scarring

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Apart from the placement of the scars, they appear hypertrophic. Scarring takes about a year to settle down. You are doing the right thing by dedicated application of silicone strips. It would be useful to know whether your surgeon sutured the skin level or used a different method of closure. It is my feeling that time invested in an optimal closure is essential because it does influence the visible result of the surgery. Scar injection may improve the scar but patients report that it is painful. I agree with other posters that your surgeon should discuss options with you and that followup care should be included in the cost of the augmentation. If you are unhappy or uncomfortable with your surgeon's suggestions, certainly seek out a second opinion.

Breast augmentation scars

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Your plastic surgeon may be overly dismissive but the reality is that there is little that can be done to improve hypertrophic scars or speed up the maturation process. Pressure can soften scars and speed up maturation but it's unrealistic in this location. Steroid injection will speed up the maturation process but won't change the width, length, position, or color of the scars. I would condemn the idea of laser treatment and scar massage or topical treatments are also wishful thinking. Occlusion with something like silicone sheeting may help speed up maturation but won't really change the outcome. 

The best that we can do is to limit the length of the incisional scar to the minimum, control the location of the scar, make sure the patient understands the scar tradeoff, close it as well as can be done and minimize healing problems, and avoid irritation to the scar while it is trying to mature. In your case I would agree that the implant may have been too wide for the position it was to fill, the incision rose up on the underside of the breast, and the length of the incision does not appear to be the minimum that can be done today (about 3 1/2 cm with a Keller funnel for silicone gel implants -- 2 cm for saline-filled implants). Unfortunately there is nothing you can do to erase the scars and start over so you will have to consider steroid injection or allow full maturation over a year or more. 

Scott L. Replogle, MD
Boulder Plastic Surgeon

Scarring After Breast Reduction

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There is a great deal of variation in the quality of scarring following breast augmentation or any operative procedure for that matter.  The only reliable predictor is previous scar formations.  It does appear from your photos that your scars would benefit from injection of steroid (I add another medication to the steroid which I feel improves the result).  I personally would charge only your insurance company or my actual cost of supplies for this service, but this will vary among surgeons.

John Whitt, MD (retired)
Louisville Plastic Surgeon

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.