Should I laser my breast lift scars?

Question

I had a periaerolar mastopexy. I have all the usual issues: thick scar, vein growth around scar area (sunburst ing appearance)- I also had some vein growth where implants stretched my skin- would you recommend laser for veins or scar? Any downside to laser? Will it do more harm to my skin than good (will laser damage my skin?)

Raffy Karamanoukian, MD, FACS · Answer

Plastic surgery scars require attention after surgery so that they remain cosmetically-appealing and barely noticeable. In our office, we use a protocol for scars that minimizes their activity in the 6-8 weeks after surgery. If you have late plastic surgery scars, you may also require laser and RF therapy to help reduce the longterm effects of the scarring. Keloids, hypertrophic scars, widened scars, red scars, and hyperpigmented scars all require scar modulation with topical creams followed by lasers and RF therapy. Topical skincare should be directed to a specific need, whether for pigmentation or hypertrophy and our office can guide you through the process to obtain the correct Plato’s Scar cream or Melarase cream for hypertrophy and discoloration. In terms of lasers, we would employ the vbeam laser for redness, Venus Viva RF, PRP microneedling, chemical peels, and Morpheus 8, fractional erbium, or fractional co2. All of these have their individual benefits. Most of all, we recommend you visit a solid plastic surgeon who understands surgical scar revision, laser therapy, and RF therapy for scars. 
 
Best, 
Dr. Karamanoukian
Realself100 Surgeon

Paul M. Parker, MD, FACS · Answer

Not sure how long ago you surgery occurred. The combination of silicone sheeting (or gel) along with massage to the scars can be helpful in getting them to mature and soften over several months. Sometimes an injection of steroid and 5 FU can be helpful in flattening scars. Lasers can improve the redness and level the scars. Finally, scar revision whereby the thickened scar is excised and the wound closed under less tension can improve scars. Follow up with you surgeon so they can monitor your progress and help optimize the way your scars heal.

Lewis Albert Andres, MD · Answer

It is common for scars to fully mature for up to a year. In the meantime, there are a few things that may help to ameliorate your incision/scar. The most proven (as well as cheapest) modality is simple scar massage. Applying pressure and massaging the well-healed scar has been shown to improve the appearance as it breaks up the scar tissue, hopefully producing the finest scar as possible. Other things that have been shown to add some benefit, albeit controversial, are silicone sheets, hydration, and topical steroids. In addition, avoidance of direct sunlight to the incision will significantly help the appearance as they tend to discolor with UV light during the healing process. If unsightly scars are still present after approximately a year's time, other things that your surgeon may consider are intralesional steroid injections, laser, or just surgical revision of the scar itself.  It appears as if you had a breast lift at the same time?  Depending on the time from the procedure, some of these modalities or laser therapy may help.  However, scar revision may certainly be entertained, which could be performed at the same time as any revisionary procedure, if you are unhappy with the result.Hope that this helps!   Best wishes!

Allen Gabriel, MD, FACS · Answer

Without any pictures, it is very difficult to make a recommendati.   Scar revision is always an option if you are not happy with your scars.  Laser treatment with ND:YAG has shown some promise in red and hypertrophic scars.  Please follow up with your plastic surgeon and have a detailed discussion.

Vincent N. Zubowicz, MD · Answer

The periareolar mastopexy puts tension on the incision which is a recipe for a bad scar. Inflicting thermal damage on the scar using the laser is very little chance of making a significant difference. A scar revision with a vertical limb to remove tension is a much better alternative.

Stephen M. Davis, MD, FACS · Answer

One thing I don't know is; how old is your breast lift? Ideally I would wait 9-12 months for the scar the be as mature as possible, that is soft, relaxed and flat as possible. Doing this would also allow for the surrounding skin to also relax. This is the point where I would consider a scar revision. To help mature the scar faster silicone sheeting works very well but it is a 3-4 month commitment wearing it 23 plus hours per day. Lasers are just going to add extra thermal ( burning / heat) damage to the tissues which will have to heal with inflammation and subsequently more scar formation.Good LuckStephen M. Davis, MD, FACSGreen Hills Plastic Surgery

Should I laser my breast lift scars?

Answers (6)

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