How to treat breast lift scar with poor healing? (Photo)

Question

Is it ok to use a hydro colloid dressing like duoderm on my mastoplexy wound? I'm 3 weeks post op and have this area of slough. I went into the clinic and saw the RN. I have been advised to keep using the fixomull tape over my scars including this area that is not healing well and change weekly. I was wondering if duoderm would be better - to help remove the Slough and speed wound healing. I'm not due to see my Dr for another couple of weeks

Larry S. Nichter, MD, MS, FACS · Answer

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:

Minimize tension on the scar. Steri-Strips and/or surgical tape are often placed in non-hair bearing areas at the time of surgery 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”. In the first few weeks after surgery, I recommend the use of Embrace Scar Therapy which is an adherent silicone sheeting pre-stretched when applied so as to offload tension on the scar.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 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.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. The best product available in my opinion is the Embrace Scar Therapy System by Neodyne BioSciences, Inc. available in many surgeons’ offices. Essentially this is an adherent silicone sheeting pre-stretched when applied so as to offload tension on the scar. For areas that are not applicable for this product (e.g. smaller areas or on the face), I prefer BioCorneum or Kelo-Cote products 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).. 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.

Jaime S. Schwartz, MD, FACS · Answer

I appreciate your question.

wait at least 12 months before revising the scar

The best way to assess and give true advice would be an in-person exam.  Please see a board-certified plastic surgeon that specializes in aesthetic plastic surgery.

Best of luck!

Dr. Schwartz

Board Certified Plastic Surgeon

#RealSelf100Surgeon

#RealSelfCORESurgeon

Jed H. Horowitz, MD, FACS · Answer

All surgical procedures carry some degree of
risk Any breast operation can result in changes in sensation. This happens less
with lifts than reductions but is still possible Occasionally, minor
complications occur and do not affect the surgical outcome. Major complications
associated with this procedure are rare. The suitability of the breast lift
procedure and specific risks may be determined during your consultation.

#Hypertrophic or #keloid scars can be a
problem. The worst are usually under the breast with an #AnchorLift or inverted
“T”. These can be treated like all thickened scars with re-excision, laser,
kenalog/5-FU injections, creams, silicone strips and other methods to reduce
and improve healing.

Keith Denkler, MD · Answer

Your incision needs wound care and time to heal.Duoderm seems like it would be difficult to apply over this uneven surface but would be fine if you can do it.

R. Laurence Berkowitz, MD · Answer

The lower end of a vertical pattern incision because it is gathered frequently has some delayed healing but ultimately is preferable to the addition of a horizontal scar.  This will heal over the next two to three weeks and with external silicone therapy should give a good result

Curtis Wong, MD · Answer

as it is the rule to have minor issues at the bottom of your incision.  It will heal with good wound care and flatten as well.  If it doesn't flatten to your satisfaction, a small revision done in the office will take care of it.  Please don't lose sleep over this as it will resolve.

How to treat breast lift scar with poor healing? (Photo)

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