Breast augmentation scar 1 yr post op. Is this a keloid scar? What kind of treatment would help? (Photo)

Question

I had underwent a breast augmentation surgery exactly one year ago. My scars have unfortunately not healed well. The right side seems to be flat but still kind of red and the left is partially raised and is also red. My question is would the left scar be considered a keloid scar? And do I need steroid injections? What kind of treatment would help with these scars. Thank you

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

Nelson Lee Novick, MD · Answer

The elevated scar appears to be a hypertrophic scar. These are characteristically raised, but, unlike keloid scars do not spread out beyond the borders of the scar. If this is indeed so, then intralesional injections of a steroid in an appropriate concentration and amount would be the simplest treatment of choice. For the flat reddish mark (post-inflammatory erythema), professionally performed microneedling along with the topical application of tranexamic acid and oxymetazolene can be quite helpful for speeding the fading the unwanted color and for improving any surface textural irregularities that typically accompany this issue. Make sure to consult an experienced, board certified cosmetic dermatologist. Best of luck.

Daniel Barrett, MD · Answer

Dear CanadaF2020,
I understand you are concerned with the appearance of your scars. As your scars heal, it should flatten out and lighten. Loss of pigmentation or hyperpigmentation may also be experienced but will resolve over time. Always follow your surgeon's post operative care instructions when it comes to scar management to avoid any complications like infection and for faster healing and recovery.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Alexander L. Berlin, MD · Answer

Hello!You have a hypertrophic scar in the left photograph. It’s more prominent than a regular scar, but not as prominent as a keloid (which is defined as a scar that outgrows its original bounds). The best treatment for a hypertrophic scars is steroid injections, but usually quite a bit fewer in number than for keloidal scars. That should improve the thickness of the scar. As for the redness, lasers, such as the pulsed dye laser, would be an excellent option for both scars.Hope this helps!

Breast augmentation scar 1 yr post op. Is this a keloid scar? What kind of treatment would help? (Photo)

Answers (4)

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