Breast Reduction and Lift Scarring - How Bad Are They?

I am 18 years old and considering a breast reduction and lift. I want to have this surgery done so bad but my only concern is the scarring. Therefore, how bad are the actual scars and will a type of cream or lotion help reduce the appearance? HELP!

Doctor Answers 19

Breast reduction and lift scarring - how bad are they?

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Hello! Thank you for your question.  These procedures are tolerated very well by women. Incisions are well hidden and usually heal very well on the breast. You may have an incision around your areola and possibly vertically down your breast and in the breast crease. 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 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 for a wonderful result!

Breast scar management

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Thank you for your question. Breast incisions can be managed using a multimodal approach:
1) Scar massage - starting as soon as the surgical dressings come off and the incisions are sealed
2) Silicone sheets or scar gels for about six months to year
3) Embrace - a tension reducing dressing for the first 2 months
4) Fractionated lasers to help blend the scar into the background - done as a series, starting about 4 weeks after surgery and repeated every four weeks for six months.
5) Sunscreen to prevent the scars from darkening

Scarring Is A Concern For Most Patients...

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It’s not unusual for patients to be concerned about scarring following breast reduction surgery, because of the length of the scars associated with this procedure. The scars are typically located around the areola, in the inframammary fold and vertically between the areola and the inframammary fold.
In an effort to minimize scarring, a variety of maneuvers have been utilized. These include techniques designed to decrease tension on the wound closure. Examples include steri-strips, silicone scar sheeting and compressive support bras.
Massage of scars with a variety of topical agents has been shown to be helpful as well. It’s also important to avoid sun exposure and tanning. In the occasional patient who develops hypertrophic scarring, steroid injections may be helpful as well.
It’s important to remember that wound remodeling occurs for at least 12 to 18 months following surgery. If you’re concerned about scarring following breast reduction surgery, it’s important to discuss this issue with your plastic surgeon. Your surgeon should be able to help you manage this problem.

Breast Reduction and Lift Scarring

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The scars depend on the scope of the surgery and the experience/expertise of the surgeon. Consult with 3 experienced and expert board certified plastic surgeons to understand your options.

Scars and breast reduction

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Some of our breast reduction patients are the happiest that we have in the practice. These are the women with significant bra strapping, back and neck pain. If you are going to reduce the size of the breast significantly, you most likely will have scars. Scars are permanent. They end to fade over time. We have our patients keep the scars away from UV light, and use scar cream. We can talk about scar revision, but usually wait at least a year.  Please see a board certified plastic surgeon.

Breast Reduction/Lift scar Reduction

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First I would recommend finding a board certified plastic surgeon that has great experience with short scar, lollipop breast reduction/breast lift technique to see if you are a good candidate for this procedurel

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:
  1. 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”.
  2. 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”.
  3. 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.
  4. 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.
  5. 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.

Breast Reduction Scar Management?

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Breast reduction surgery is one of the most patient pleasing operations we perform. Although there are many benefits of the operation patients should consider the presence of scars ( and the potential for unsatisfactory scarring)  in their decision-making.
Time tends to improve the appearance of scars. You will find that the scars will improve in appearance even after a year has gone by. Sometimes the use of silicone-based products  can be helpful. In the event of unfavorable scarring steroid injection may be helpful. The use of superficial radiation treatment is possible for symptomatic scars.  Sometimes scar revision surgery and careful scar management afterwards may be helpful. Despite anecdotal reports I have not seen significant improvement with laser treatment of scars.
Best wishes.

Predicting scars from breast lift (mastopexy) and reduction

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There are no magic creams that will prevent scarring. Scars are 50% the surgeon's technique and 50% your genetic response to that injury which cannot always be controlled. Scars can range from very fine white lines to to thick rope-like scars and everything in between. 

Scars after breast lift can be minimized

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In order to get the best shape and size of breast with a lift some incisions around the areola and under the breast are necessary.  In most patients these incisions can be very minimal after four to six months with proper care.  This care begins in the operating room with layered closure and minimal sutures on the surface.  This is followed by prolonged scar therapy with proven techniques of placement of special sheeting over the scars for an extended period of time.  In the event a bad scar is incurred then a scar revision may be required.


Tal Raine MD

Breast scars in lifts and reductions

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There are mainly three factors involving permanent scars that are required to lift and/or reduce breasts. These are their length, their location, and their appearance. 

Experienced plastic surgeons today can limit the extent of the scars on the breast to around the areola and from the areola down to the inframammary crease (a "lollipop" incision) and can close the incisions as well as anyone can, but there is no way to guarantee how they will look or how you will feel about them. 

As for reducing scars or their appearance, there is nothing that actually works to improve on normal scarring. There are some things that can be done to limit or reduce abnormal or excessive scarring but have no influence on normal healing/scarring and pigmentation. Most of the creams and topicals are wishful thinking but probably won't harm anything. 

When breast scars are fully matured (can take a year or more) it is reasonable to consider permanent makeup for them which is tattooing in skin color, particularly around the edge of the areola. 

Scott L. Replogle, MD
Boulder 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.