No Crease. Bad Scars. What Can Be Done for Some Improvement? (photo)

I had a breast lift almost a year ago. The results are terrible and I feel disfigured. Hard for me to even post these pictures. I have a 450 implant placed over the muscle. Scars appear hypertrophic. Implants too heavy and causing stretching of skin and more stretch marks. Right nipple stretching. & My MAIN concern is that I don’t have an inframmary fold and that horizontal scars are not hidden!!! Can this be fixed? Breast be raised to create a fold? What can be done for some improvement?

Doctor Answers 9

Unacceptable scarring after breast reduction

Your scars are hypertrophic and it is easy to understand your disappointment - I would recommend finding a plastic surgeon who does many revisions - this can alomost definitely be made much better . Also, consider the use of embrace, a scar treatment product by Neodyne which recently gained FDA approval and can help tremendously in relieving tension after your revision, resulting in better scar quality.

Las Vegas Plastic Surgeon
4.9 out of 5 stars 294 reviews

Scars and breast shape after mastopexy and augmentation

Thank you for the questions and photos. You do have some wide scars, and this is a challenging problem as it is impossible to know what your scars might be after a revision, meaning they could look the same after revision. However, I do think you would likely see an improvement with a scar revision. I think you would probably benefit from a revision of at least the lower pole of your mastopexy as your nipple position may be correct. This is difficult to determine without an exam. If you feel your implants are too heavy and pulling this is definitely the time to downsize to reduce the weight on the mastopexy scars. 

Shannon O'Brien, MD
Portland Plastic Surgeon
5.0 out of 5 stars 4 reviews

This result is worthy of a revision.

The mastopexy needs to be totally redone for an acceptable result. It should also be a time to reconsider the size of the implants.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.7 out of 5 stars 35 reviews

Scarring 1 year post-op from mastopexy

At one year following your surgery, your scars and breast shape are most likely stable and mature, and thus, I would not expect any further changes.  Thus, if you are not happy with your current appearance, you will need to contemplate revisional surgery.  It will not be possible for me to give you a specific plan for what to do to improve your breasts without a good exam in person, however, based upon what you have told us and what is shown in your pictures, I think you should think about a couple of possible scenarios.  You should consider that you will possibly need to redo the mastopexy procedure completely to remove all existing scars.  You should also consider that you may need to exchange your implants for smaller silicone gel implants, and have them placed under the muscle.  There may be other particular strategies involved too, including the use of products called "ADM's" or Acellular Dermal Matrix, which are special grafts that may be necessary to hold the positions of the implants.  My best advice is to have a consultation with a board certified surgeon who is experienced in complex revision procedures on the breast and can advise you properly before proceeding.  Good luck. 

Joseph L. Grzeskiewicz, MD
San Diego Plastic Surgeon
4.9 out of 5 stars 87 reviews

No Crease. Bad Scars. What Can Be Done for Some Improvement

Thanks for your question and for the attached photos. The shape looks satisfactory. To my eye, most or all of the problems here are related to the scars, which are hypertrophic. There appears to be a fold. 

I can understand your desire for better scars. I don't know from the question whether some of the non-operative remedies have been tried--scar creams, kenalog injection, and so forth. Sometimes these help and avoid surgery. However, if you do have surgery for the scars I would consider moving the implants to under the muscle, and using smaller implants.  There will be no certainty that the new scars will be better than the current ones. If your surgeon thinks these are "bottoming out" consideration should be given to  reconstructing the breast fold with Strattice. 

All the best.

Jourdan Gottlieb, MD
Seattle Plastic Surgeon
4.6 out of 5 stars 45 reviews

Improving Previous Breast Lift Results?

Thank you for the question and pictures. Based on your pictures, it is clear that your breasts have lost alot of their skin elasticity; for example, your breast skin demonstrates significant stretch marks etc. I think that this loss of skin elasticity may explain why the scars are so poor. I think you will benefit from scar revision surgery which will improve the outcome of the procedure significantly.  The use of silicone-based products postoperatively may also be helpful. However, creating a breast fold will be much more challenging,  unpredictable and potentially unsuccessful.

 Especially given your level of dissatisfaction ( and  almost palpable frustration), make sure that you achieve realistic expectations prior to proceeding with any additional surgery.  Otherwise, it is very likely that you will continue to be disappointed despite your plastic surgeon's best efforts.

 Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,488 reviews

No Crease. Bad Scars. What Can Be Done for Some Improvement?

       When you perform hundreds of breast lifts a year, you occasionally run into a patient in whom the tissues cannot sustain the native tissue let alone a 450 cc implant.  This is probably not the case here.  You could consider submuscular placement with scar revision and possible dermal matrix to prevent bottoming out as well as implant size reduction.  Find a plastic surgeon with ELITE credentials who performs hundreds of breast lifts, breast augmentations, and breast lift revisions each year.  Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results.  Kenneth Hughes, MD Los Angeles, CA

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 492 reviews

Scarring after lift and augmentation

While the scars can be revised and your pexy revised as well, the scar final results is hard to predict and may look similar to what you have now.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Hypertrophic scarring after a breast lift, anchor type

You do have some extensive scarring from your anchor breast lift.  These appear to be hypertrophic in nature.  AT this point a scar revision may be considered along with revision of your mastopexy and possibly a downsizing of your implants.  Over all the shape is not bad.  Scarring is very unpredictable.  I believe that your main problems can be improved but no one could guaranty an improvement in the scarring the next time. 

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 19 reviews

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.