Excessive itching post-op 6 months mastoplexy?

Question

I had abdominoplasty/lipo/ mastoplexy on May 31. No complications, normal recovery. Lately my incision scars on my breasts are itching like crazy. It's driving me insane. It's both breasts and every part of the incisions, including the nipple area. Is there anything I can do? Will it go away? Does this sound normal? I don't even want to wear a bra because it's makes the itching worse.

Jed H. Horowitz, MD, FACS · Answer

HEALING AFTER SURGERY

1.   
pain is variable

2.   
it takes 2-3 months for implants to settle and muscles to relax

3.   
celebrex, motrin, and muscle relaxers can help

4.   
massage and stretching may help

5.   
everyone heals differently

6.   
4-7 days off from work is common

HEALING OF SENSORY NERVES: Tingling, burning or shooting pains, which will disappear
with time and should not alarm you, indicate regeneration of the sensory
nerves. If these sensations cause pain, repeated, local self-massage helps.

ASYMMETRY: The two breasts commonly heal quite differently. One
breast may swell more, feel more uncomfortable, or have a different initial
shape. After complete healing, they will be more similar and natural. You must
have patience, but if this causes concern, ask questions of the doctor or the
nursing staff.

SHAPE AND CONTOUR: The final shape of your breasts will start to look its
best approximately three (3) months after surgery. It takes time for the skin
and muscle to stretch and relax around the new implant. The breast will often
look higher, firmer, and “less natural” in the first three (3) months. It can
take up to a year to see your final result.

FOLLOW-UP EXAMS: These are generally done in 1 week, 2 to 3
weeks, 3 to 6 weeks, 3 months, 6 months to 1 year, and 1-2 year intervals. In
our office we include all of your follow up appointments in the initial
surgical fee.Having been six months, if you are concerned about the itching that you feel it would be good to have another follow-up with your surgeon to have the area examined and make sure that healing is going as it should or if something needs to be done to help resolve the issue. Good luck.

S. Larry Schlesinger, MD, FACS · Answer

Thank you for your question.  It's a definite "who done it"1.  The only itching that you are having is on the breasts, not on the abdominoplasty or the liposuction areas, yet all areas have scars.  This makes me think that this problem is related to your breasts and not to the other areas that were operated on the same day with the same instruments and more than likely the same sutures.  Since it has also been 6 months, this makes the problem very unlikely to have originated in the operating room.2.  You have itching not only on the suture line but the entire breast.  For me, this eliminates a chance of nerve endings being trapped in scars on the breast.  Also, it is unlikely that the scars on the breasts are much different than scars on the abdomen.  3.  At 6 months, it's possible that you look so good that you might go to a topless beach, but post op scars can be taken into the sun after 90 days with minimal side effects, therefore I doubt sun exposure as the causative agent.  Therefore, I must conclude that it is a garment worn on the breasts that is the culprit or the vector that's carrying the culprit.  Either you are wearing a new bra that you haven't worn before because your breasts are now settled and look great or you are using a new laundry detergent to which you are allergic.  Of course, all the above is just an assumption and we know where assumptions lead to.  If I were you, I would seek an in person meeting with your plastic surgeon and get his or her opinion as to what the problem may be.

Nelson Castillo, MD · Answer

Thank you for sharing your question. Without photographs it is difficult to offer you definite recommendations as itching this far out from surgery is unusual. I would be concerned of either the development of hypertrophic/keloid scars or a contact irritant.  See your surgeon for an in-person examination.

Camille Cash, MD · Answer

It is not typical for the itching to begin so suddenly and at 6 months after surgery.  Are the areas red? Any other symptoms?  It may be a contact reaction to a new soap or detergent.  I recommend talking to your surgeon about the situation as he/she is most familiar with the details of your surgery and how you've progressed through recovery.

Excessive itching post-op 6 months mastoplexy?

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Excessive itching post-op 6 months mastoplexy?

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