What is the best treatment option for my breast reduction scars? (Photo)

Thank you for your question and for sharing your concern.

For scars that are four years old post-breast reduction surgery, complete removal is unlikely, but several treatments can significantly improve the appearance, texture, and color of the scars. Based on the photo, the scars appear mature and hypertrophic in some areas. Here are the best treatment options to consider:

Fractional Laser Resurfacing (e.g., CO₂ or Er:YAG laser)
This is effective in improving scar texture, reducing redness or pigmentation, and softening raised areas. It works by promoting collagen remodeling deep within the skin.

Silicone Gel Sheets or Silicone-Based Creams
These are non-invasive and best for ongoing management. They help hydrate the scar tissue and flatten raised scars over time.

Steroid Injections (Intralesional Kenalog)
If the scars are raised or thickened (hypertrophic or keloid), steroid injections can help flatten them and reduce itching or discomfort.

Microneedling with or without PRP (Platelet-Rich Plasma)
Microneedling stimulates skin regeneration and can improve scar texture and color, especially when combined with PRP.

Topical Retinoids or Lightening Agents
These can improve hyperpigmentation or uneven color in the scar. Agents like tretinoin or hydroquinone may be used under medical guidance.

Surgical Scar Revision
If scars are significantly raised, widened, or poorly aligned, minor surgical revision may be an option to improve their cosmetic outcome.

It’s important to tailor treatment based on your skin type, the nature of the scar, and any history of keloids or pigment changes. A combination of therapies often yields the best result for mature surgical scars.

Thank you for your inquiry! By your photos, you would be a great candidate for a scar revision procedure. Scar creams can be used on scars to minimize appearance as well as silicone scar sheets. Lasers such as Microneedling can also be performed to minimize appearance as well. We would love to see you in person or virtually to discuss treatment options or schedule a consult with a licensed aesthetician and/or a board certified plastic surgeon.

Our office has many different treatments for scars depending on the depth of atrophy or hypertrophy. Scars require a combination approach using our HI DEF protocol which uses a combination of lasers, topical scar modulation, and RF treatments to pixelate scars, improve contour, reduce hyperpigmentation, and improve the visibility of the scars so that they are no longer visible in ambient light. Everyone has a unique pattern of scarring and we employ our HIDEF technique to improve texture, color, contour, and topography. We often use a combination of treatments that begin with a careful examination to examine the micro texturing of the acne scars. Atrophic scars and indented scars can benefit from injectable fillers such as Radiesse, Sculptra, and Restylane with or without subcision to remove tethered scars and atrophic depression. Hyper-redness in scars can be improved with V beam laser, Excel V, BBL, IPL, and Venus RF to improve the redness and reduce the visibility of deep scars. Fractional Thulium laser and clear & brilliant can also reduce the inflammation and redness of the scar when combined with topical therapy. Fractional lasers such as Fraxel, erbium, and CO2 laser can be combined with radio frequency and also fractional RF to improve textual issues and microtopography. Subcision and TCA cross are also used for deep ice pick scars and narrow valley scars in order to improve the micro texture. Above all, our combination approach with our clinical nurses and board-certified plastic surgeons can improve the quality of your skin by using at home Melarase creams combined with PRP treatments in our office to improve your skin quality and tone. I recommend getting a formal evaluation with an experienced team of experts in order to reduce your scarring.

Finally, hyperpigmentation of scars can be improved with at-home Melarase AM, Melarase PM, and Melapads to help reduce active PIH and melanin deposition.

Best,
Dr. Karamanoukian
Realself100 Surgeon