Breast Reduction Scar Removal

I am a 19 year old female. I had a breast reduction in October of 2009. After surgery, I was pleased to see how much perkier and smaller my breasts were. I talked with my doctor briefly @ my 1 month follow up, asking how long to wait before exposing my scars to the tanning bed. I was told 3 months. I have been tanning regularly for months now. I now have very noticeable bright pink scars that are raised and very wide. What are my options to reduce the scarring? It seems too late to not tan :(

Doctor Answers 9

Healing takes 12-18 months, sun should be avoided during that time.

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Wound healing is a dynamic process that lasts for 12 to 18 months following breast reduction surgery.During this period it’s important to avoid sun exposure and tanning because they can adversely impact wound healing and lead to unattractive scars.
Unfortunately, once the scars have developed this type of discoloration, conservative management is almost always unsuccessful.For this reason, re-excision and re-closure are usually always indicated.Under these circumstances this approach is associated with excellent clinical results and high levels of patient satisfaction.
It’s important to consult a board certified plastic surgeon who can help with this problem.This surgeon should be able to outline a treatment plan for scar revision.

Scarring after breast reduction

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It is unfortunate that you started tanning so early. It generally takes about a year for scars to mature, and that's why I tell my patients to avoid tanning for a full year. As you can see, it has resulted in a permanent discolouration of your scars. You may want to try silicone gel or silicone sheeting, although these may not be able to reduce your scarring as significantly as you'd like. You can also try laser treatments. Whatever you do, please ask your surgeon for their advice first.

Breast Reduction Scar Removal

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Your plastic surgeon was right, you should not tan scars as it can cause permanent hyperpigmentation (brown color). Here are some tiips on how to have the best scar maturation following surgery:

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 and tanning beds. 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.

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Breast Reduction and Scars?

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Thank you for the question.

Sometimes the use of silicone-based products and/or 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 otherwise I have not seen significant improvement with laser treatment of scars.

Best wishes.

Scarring after breast reduction

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You are young, and this is typical in the natural history of scars. They tend to get a lot worse before they get better, and I have to explain to patients that it takes up to a year for a scar to fade. You can helps the process by massage with a scar cream or vitamin E. This helps mechanically soften the collagen in the scar.

Regarding the tanning bed, they are a bad idea for your skin, and certainly for your scars as well. I always recommend that my patients avoid tanning beds. They are popular though, and people love them, for sure. But in terms of light induced damage in the skin, they are as bad as the sun, and some studies suggest they may even be worse!

Srdjan Ostric, MD
Chicago Plastic Surgeon

Scarring and breast reduction

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The final scar quality after any surgery has a lot to do with tension, the type of closure, and probably most importantly is genetics.  Some people just do not heal as well as others. Sometimes topical creams, silicone sheeting,etc.. can help scars.

Options for red raised scars after breast reduction

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You first should stop exposing the scars to tanning until the red color has resolved. You may benefit from steroid injections. Other options include pressure therapy, topical paper tape, silicone gel sheeting and/or scar revision surgery

Breast reduction scars

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Breast reduction surgery always involves placing scars on the breast, and unfortunately some scars do not heal to be inconspicuous. Raised, red, thick scars as you describe may indicate scar hypertrophy, a condition which is treatable with a number of modalities including creams, silicone gel sheeting, and cortisone injections. You should consult with your plastic surgeon for intervention as soon as possible as treatment is generally more successful when initiated early.

Olivia Hutchinson, MD
New York Plastic Surgeon

No more tanning beds please!

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Best treatment at this point would be laser scar treatment  to tighten the skin and reduce the width of the scars.  I would recommend IPL treatment as well to reduce redness.  I would not advise any more tanning and would switch to kelocote scar gel.  We have had excellent results in my practice with this management of post-breast reduction scars.

Marisa Lawrence, MD
Atlanta 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.