I just had breast reduction surgery. The scars seem to be settling, and I want to know what to put on them to minimize their appearance.
How Can I Minimize Scars from Breast Reduction?
Doctor Answers 33
Breast Reduction Scar Management
A: Reducing Breast Reduction Scars
I have switched to a "lollipop" type of incison/scar for breast reductions which reduces scars by about 50 % vs a traditional anchor pattern scar.
Scar Management tips:
- Minimize tension on the scar. Embrace scar dressing is the best as it lessens tension directly on the wound. 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”.
- 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”.
- Protect your scars from the sun. Staying out of the sun is the best advice. Minimal exposure to sunlight is preventshyperpigmentation (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.
- 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.
- 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.
For best scar managment in general see my below link on best practices for scar managment.
Bio Corenum Scar Treatment
How to minimize or improve breast reduction scars
Like many plastic surgery ops, the quality of the final scar has at least two determinants: a) patient factors; b) doctor factors. Before considering any elective surgical procedure, it's important to consider whether the resultant scar is an acceptable trade-off.
PATIENT FACTORS: Many large breasted women try non-surgical options, such as extra supportive bras, chiropractic and/or physical therapy and/or weight reduction with variable "success". Once they've researched the procedure, interviewed potential surgeons, spoken with women who've had the surgery and consulted with their personal physicians, they should also have an idea of how well their old scars healed.
There are genetic factors, such as keloid scar formation, which would make breast reduction problematic. Budgeting enough time to recover and providing sufficient back-up for physically strenuous tasks is also recommended.
DOCTOR FACTORS: Experience with the technique, gentle tissue handling & aesthetic sense are essential. Equally important is excellent communication so the patient knows how to care for their wounds at each stage of their recovery.
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It is amazing how nice the incisions look after several months.
If you just had breast reduction surgery, listen to the recommendations of your plastic surgeon. Most surgeons prefer surgical tape or strips for the first few weeks. You can then progress to silicone sheets. However, they must be worn almost 100% of the time for several weeks to months to make a difference. The best thing for you to do right now is just wait. After your surgeon gives you the okay, I would recommend gentle massage over the incisions to help them soften. Scars/incisions go through a maturation process where they actually get slightly thicker (like a cord under the skin) as the collagen is rebuilding for the first six weeks. Then, over several months the incisions soften up and flatten out. When patients come back six months to a year out from surgery, it is amazing how nice the incisions look. As with all incisions, you should protect them from the sun with either clothing or SPF lotion.
Scar Management Post Breast Reduction
Breast scar management
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
"It’s The Rubbing, Not What You Rub It With"
The best treatment for scars is called scar massage. Basically this means you massage your incisions with some type of lotion. I tell my patients “it’s the rubbing not what you rub it with”. Silicone is great for scars as well. It helps to reduce the redness faster and flattens them. Many products are now available without prescription which contain silicone.
Breast Reduction and Scarring?
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. 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.
Scar sheets work well after breast reduction
Week only recommend that our patients used silicone scar sheets after a breast reduction surgery. These sheets help the scar heal in a flat and smooth fashion. The best scar sheets are typically found not in the pharmacy online. There are several vendors that are particularly effective. If you would like a list of vendors that may help please feel free to contact our office and we will forward the information to you.
The best way to minimize the appearance of scars
For many years I have used paper tape on my patients' scars. I have found that this works the best; better than silicone sheets and other products. I use 1" paper tape that is brown is color, so it does not show through clothing. The tape is put on so that it is a little tight. The patient reapplies it when it is loose. The pressure from the tape helps the scars heal very nicely. Hope this helps.
Tracy M. Pfeifer, MD, MS
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.