Laser or re-operation? What would give me the best result? (photos)

I had a breast augmentation with big lift and enlargement in February 2016. The stitches was roughly removed, 14 days after the operation, and it immediately started bleeding. The surgeon has now offered me laser treatment first, to see if it will help. Can you tell me, why my scars are so big and wide? And should I ask for a re-operation right away?

Doctor Answers 12

Laser or re-operation? What would give me the best result?

Your sutures were left in for 14 days? Highly unusual for a plastic surgeon to leave external sutures in for more than 5 to 7 days. Personally, I don't use external sutures, but rely upon internal sutures. 

It looks like you had separation of the wound in the photo. A laser would not help your scar. A surgical scar revision would be indicated. As mentioned by my colleague, a portion of the scar could be done as an office procedure to assess your result.

Thank you for your question and photos.

Scars following lift and augmentation

 I concur with my fellow PS, surgical revision is a better option. I see no advantage in using any type of laser for widened, conspicuous  scars. If the surgeon is reluctant, you might have him/her surgically revise a small area in the office .  As stated, the strength of the wound closure is dependent on the internal stitches. It would atypical for a PS to use very many external sutures on a mastopexy patient.

Don Fontana, MD
Waldorf Plastic Surgeon
5.0 out of 5 stars 13 reviews

Laser or re-op?

Hello and thank you for your question!

Based on the pictures you have posted, the best option for scar treatment would be a surgical rev. because in terms f pigmentation, your scar is very clear, but in terms of size it could be improved. Laser would not improve the size of the scar, but the pigmentation. The best line of treatment would definitely be a surgical rev.

Please visit a board certified plastic surgeon for further advice and the best, safest results.

Good luck!


Enriquillo Clime Rivera, MD
Dominican Republic Plastic Surgeon
5.0 out of 5 stars 5 reviews

Scar Revision

Based on the looks of your scars it would be best if you had scar revision surgery. Many internal stitches should be used during the closure to help prevent widened scars. The final appearance/result of the scar depends on the skill and closure of the surgeon as well as the patients body's ability to heal well.

Allen M. Doezie, MD
Orange County Plastic Surgeon
5.0 out of 5 stars 32 reviews

Laser vs revision for scars

Scars tend to heal wide when there is a lot of tension on the skin, or when there was trauma or infection after surgery.  Laser usually helps scars that are slightly raised, red, and fairly narrow. It doesn't help as much with scars that are pale or wide. Scar revision is often a better choice for this type of scar, and it's fine to do any time. But if there is a lot of tension on the scar, it may not heal much better the second time around. If you don't know if there is too much tension, you can get a second opinion or wait until 12 months after surgery to give the skin time to fully relax before thinking about more surgery. Skin color tattoo can be done for camouflage if the laser doesn't help. 

Dana Goldberg, MD
Jupiter Plastic Surgeon
5.0 out of 5 stars 32 reviews

Scars after surgery

Everyone's scars can be different even though the techniques used were similar. Hard to predict. Sometimes scar revision is worth it, and sometimes tattooing may help camouflage the area.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

Scar revision

Widened scars like this usually do better with a scar revision, rather than laser.  Did you have any post-op healing issues - like bleeding, hematoma or dehiscence (separation)?

Best to discuss the timing of the revision with your surgeon.

Breast Scar Revision

Thank you for your question and pictures. Laser treatments can help remove redness from the scars, but will not change the wideness of the scars. In my experience, scar revision with excision of the widened scars should improve the your result.

Scars

I don't think a laser treatment will help, and you will not be happy. You would probably do better with excision of the scars and re-closure.

Good luck,

Scarring After Breast Augmentation and Lift

From your photos, it appears that you have a widened and irregular scar. This can happen at the time of the surgery since there is stretch from the placement of an implant. However, it is usually possible to improve these scars at a later date since there is no additional pressure on the skin. See about a scar revision procedure. 

You should continue to follow up with you doctor to ensure you progress as planned.

Best of luck,

Vincent Marin, MD

San Diego Plastic Surgeon

Vincent P. Marin, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 42 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.