How to Prevent Bad Breast Augmentation Scar in Asians?

It is true that Asian and darker skinned individuals have more of a tendency for ropy scars. 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. See the below link with simple tips on how to prevent bad scars

Hello! Thank you for the question!  The typical incision used for breast augmentation are: inframammary (in the fold beneath your breast), periareolar (at the border of the areola), axillary (within the armpit crease), and TUBA (through the umbilicus). Incision placement will do a lot with your preference, surgeon comfort level with that approach, and the type of implant - silicone implants will be difficult to place within certain access incisions. Breast augmentation scars are well concealed and are very discrete. They should not be visible within clothing, and likely hidden without clothing. If your concern is the visibility without garments, you should consider remote access incisions such as in the armpit. However, these other incisions heal very well on the breast and often times inconspicuous. 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.Consult with a plastic surgeon your goals, concerns, and expectations. Certainly incisions should be considered, but should not limit your overall result by hindering visualization and access to your surgeon, and what produces the best results in his/her hands.Hope that this helps! Best wishes!

Hi there-
It is true that patients of Asian descent are more prone to darkening of their scars than caucasian people, regardless of their location.
The peri-areolar scar has the advantage of (hopefully) being hidden in the border of your areola...
The fold incision has the advantage of being under your breast (hidden by your breast)...
I would think of it this way- if you developed a dark scar after surgery, in which location would it bother you the most?
In either case, know that with proper management, post-inflammatory pigmentation can be successfully improved over time with bleaching creams.

Unfortunately, genetic tendencies result in Asians having a reportedly sixfold greater tendency to develop keloid scars when compared to caucasians. Despite the best of techniques, prevention may be impossible. Use of an immediate intra-areolar scar can dramatically reduce this tendency but there may be other reasons why surgeons prefer the use of a fold scar when placing silicone implants due to concerns with biofilm formation as well as limited size of the areola

Generally speaking as the skin tone gets darker the propensity for more pronounced scarring increases. This is a generalization as the majority of people heal very well. Surgical technique and tissue handling are also very important. Post operatively I find silicone sheeting is the only product which works consistently to minimize the occurrence of raised scars. All this being said, I anticipate and excellent result for you.
All the best.

One of the more challenging skin types in my practice are my Vietnamese patients who have pearly white skin, but may heal with a darkened scar. A gel implant will of course require a longer incision and you will want to keep that in mind.
Scars under the breast are typcally not visible except when you lie down, and for this reason I prefer them. Although I am not a big fan of the armpit incision, about the only time I will offer it is in patients who I feel have a tendency to make a thick or dark scar.
Postop scar care can of course help scars do a little better in most cases.

It is hard to predict how an individual will heal from surgery. The best way to tell is looking at other scars you have from previous surgery or accidents. In the absence of this information, you just have to count on your body healing well. Avoiding smoking and having a balanced diet are factors which can help you heal better. There are also products which you can use post operatively to help the healing process. Good luck.

Every person heals differently and will improve over the next 3 to 6 months.  If your scars have widened then you may want to consider a scar revision.    Some patients require up to one year to fully mature.  A nice scar starts in the operation room. The incision must be placed in the right position, sutured keeping the tension off of the skin itself.  Also it has been show that keeping the incision taped for the first three weeks keeps some of the early tension off of the scar.  Then from the end of the third week to the end of the third month it helps to use a topical product with silicone.

Thank you for the question.

Generally, I prefer the infraareolar  incision for  Asian breast augmentation patients.  I have found that this incision line tends to blend in as much as possible with the areola pigmented skin.

Best wishes.

Choosing the best incision for breast augmentation


There are basically four choices of incision for placing breast implants  - Inframammary, per-areaolar,  transaxillary and trans-umbilical.  Choosing the incision for placement of the implants which is best in any given situation can be affected by many factors – these can be broken down into patient specific factors and surgeon specific factors.




Patient specific factors include ethnicity and tendency for poor scarring (some ethnic groups have a propensity for hypertophic or even keloid scarring), pre-existing anatomy (e.g.  Is a given patient’s areolae large enough for placement of a pre-filled silicone implant?)  Given the propensity for hyperpigmenting and hypertrophic scars in Asian patients,  I often lean towards the peri-arealoar incision if I think the implant (I use mostly silicone) can fit through the incision.




Surgeon specific factors tend to include the biases and experience of the surgeon, which should not be discounted or taken lightly. 




My personal experience after over 3000 breast augmentation is that inframammary and peri-areolar incision give the most control over the breast implant pocket and that transaxillary and trans-umbilical incision have a higher revision rate.