Brown Spots Beside Breast Lift Scars

The most likely explanation of the peri-scar hyperpigmentation is a process known as post-inflammatory hyperpigmentation. This occurs during the healing phase of a scar wherein the inflammatory healing cells stimulate pigment deposition. The process can be minimized by the judicious use of skin lightening agents postoperatively.

It is impossible without an examination to say with certainty what the cause of this is, however, sometimes some of the brown skin of the areola gets transferred to the underneath side of the breast and can show up along the vertical scar under the areola.  If this occurs, it is very simple to correct at a later time simply by excising a little bit more skin along the vertical scar.  This can usually be done under local anesthesia with minimal pain or downtime.

Without a picture and without examining you, it is really difficult to give you an idea of what is going on.  My best advice would be to follow up with your surgeon for an evaluation.  In some cases, scar can have pigmentation issue but there are creams that are very effective at helping this.  Good luck.

Hyperpigmentation is the response of melanocytes to trauma.  Surgical incisions are traumatic and hyperpigmentation can be a response to this.  Most of the time it will fade as the inflammation subsides over months.  Bleaching creams can help but they should be used judiciously.

There are a few causes for this:
Any scar which is expsosed to prolonged inflammation (especially in a dark skinned individual) can develop post-inflammatory hyperpigmentation.
Inflammation can be caused by:

prolonged sun exposure
skin blisters
tape reaction
low grade fungal infections
excessive moisture
suture (stitch) reactions
etc

Postinflammatory hyperpigmentation resolves over time but it may take a year or two. Occasionally mild steroid creams may help but I would consult your physician.
There is one other possibility: retention of areolae. In the case in which a very large areola is reduced, it may not be possible to excise the outer areolae. some of it can be transferred to the vertical scar. This will make the vertical scar look like it is surrounded by a mole when it really is the areola.
I hope this answers your question.

Hello,

We need to know what these pigmented areas might represent before we can figure what to do about them. Have your surgeon take a look.

 

Best Regards,

 

John Di Saia MD

There are a number of possible causes for the brown spots around the scars on your breast, though most likely they represent post inflammatory hyperpigmentation. This condition tends to develop several weeks to months after surgery, and may be treated with topical bleaching cream if it does not resolve on its own.

 

The way your skin reacts after a breast lift surgery depends largely on the technique used for the procedure. If the procedure employed techniques that required a great deal of tension on the skin to retain the breast shape, you may expect wide scars and skin color changes. For this reason, in our practice, we use techniques that employ very small incisions and stress creating an internal framework within the breast mound to help keep the breast shape. Once the shape of the breast has been established with this internal suturing, we may then drape the breast skin over the breast tissue and close the incisions with minimal tension.

As the other plastic surgeons responding to your question have accurately pointed out, you probably have post-inflammatory hyperpigmentation following your breast lift (mastopexy).
Hyperpigmentation (darkening of your scar and/or the tissues adjacent to it) is due to increased melanocyte (pigment cell) activity due to inflammation from surgical healing. It occurs most commonly due to:
1. Delayed wound healing, causing a prolonged inflammatory response.
2. Repeated scratching of or picking at the incision site.
3. Darker skinned patients (who have more melanocytes in their tissues).
4. Premature sun exposure of the scars.
There is no easy solution. Bleaching creams may help, especially if used in the first few months after surgery. Avoiding picking at the scars or sun exposure to the scars may help. Occasionally scar revision may be helpful.

The brown spots you mention can really be from a whole host of things. This can be from healing issues that occur secondarily, post-inflammatory hyperpigmentation, retained skin elements, etc.. Speak to you doctor about this.