3.5 months post-op breast lift (no implants): are my scars on track to heal normally? (photos)

Question

I'm happy with the results of my BL overall. The shape and the degree of lift are good. As you can see looking at the before pic, but the results are pretty dramatic. My only concern is that my scars don't appear to be fading as quickly as others I've seen here at 3.5 months. Should they still be this red/uneven (wider in some places than others)? Should I be using anything at this point to speed the healing process?

Larry S. Nichter, MD, MS, FACS · Answer

Best Scar Management is important to minimize or completely hide from view, the telltale signs of your surgery—namely, scars. Both you and your surgeon want you to have the most minimal scarring possible. There are many possible causes for scars that are enlarged or not healing well. Unsightly scars are most commonly due to genetics, underlying medical conditions, or improper scar/wound care. The last part is very important and patients can make a noticeable difference in their scars’ appearance by following best scar management practices. Here are some simple tips.
Scar Management tips:
Minimize tension on the scar. Steri-Strips and/or surgical tape are often placed in non-hair bearing areas at the time of surgery to minimize tension and keep pressure over the scar.  This minimizes the  stress that  can pull the scar apart (dehiscence) creating a wound and  delaying healing time, and can make the scar wider, or more “ropy”. In the first few weeks after surgery, I recommend the use of Embrace Scar Therapy which is an adherent silicone sheeting pre-stretched when applied so as to offload tension on the scar.Keep your incision site/scar clean to prevent infection. Follow your surgeon’s wound care instructions to the letter with out modification. Never apply different products then recommended without first discussing them with your surgeon. This is especially important during the first few weeks. If there are any signs of infection, contact your surgeon’s office right away and/or see your doctor or his nurse immediately. Typical signs of infection may include redness outside the immediate incision site, asymmetric swelling, and drainage, of pus, fever, chills, and “feeling sick”.Protect your scars from the sun. Staying out of the sun is the best advice. Minimal exposure to sunlight is prevents hyperpigmentation (permanently turning brown) and other problems that can make the scar more noticeable. Sunscreen, at least 30 SPF and an overlying make camouflage make up additionally protects the scar from the suns harmful rays. This advice is especially important the first year following your surgery.Use specific scar maturation products recommended by your surgeon. Patients seem to have their own opinions on this touting everything from Pure Vit E, Coco butter, to Aloe Vera, etc but most have minimal benefit other than keeping the scar hydrated. Although hydration is important there are better, scientifically studied products with greater efficacy. Most of the scientific articles written about this subject indicate that topical silicone gel or silicone sheets work the best. The best product available in my opinion is the Embrace Scar Therapy System by Neodyne BioSciences, Inc. available in many surgeons’ offices. Essentially this is an adherent silicone sheeting pre-stretched when applied so as to offload tension on the scar. For areas that are not applicable for this product (e.g. smaller areas or on the face), I prefer BioCorneum or Kelo-Cote products There are a lot of products to choose from, but silicone should be one of the key ingredients. Although Mederma, an onion extract derivative active ingredient rather than mainly silicone based may help, primarily silicone based products are better and many also contain other ingredients that may be synergistic (hydrocortisone or other steroid, Vitamin E, Sunscreen, etc).. If the reader has problems obtaining these they can call my office. Patient compliance is also critical – use often and according to directions or it will not work optimally. NEVER apply products without first discussing them with your surgeon.Monitor to make sure your scar is progressing optimally. Keep your scheduled follow-up appointments with your surgeon to verify that your scars are maturing as expected.  Occasionally if indicated you may need a topical steroid preparation or even a series of  injections (5-FU and/or Steroids) or laser treatments  to treat or  prevent scar hypertrophy or keloid formation (red raised scars), or other topical medicines to treat post inflammatory hyperpigmentation (brown scars) with prescription creams and possible laser treatments.#scarmanagement

Gregory C. Gaines, MD · Answer

Thank you for your question!
Although the pink can be a little intimidating and worrisome, it is completely normal at this stage. We encourage our patients to be patient, it can often take a full year before the scar is completely healed and faded to a nice light skin toned color. We do recommend to always wear sunscreen on the scars when you are in the sun, even under clothing as not all clothing is an SPF of 30 or higher, damage from the sun can cause a permanent darkening of the scar. Silicone scar strips and other creams such as Mederma have shown promise when it comes to lightening the scars a little faster. Remember to consult with the Surgeon who performed the procedure before attempting anything new on your breast.

Dhaval M. Patel, MD · Answer

Thank you for your question and sharing your photos. Everybody heals differently but this looks normal for about 3 months. Scars fade differently for everyone depending on their age and skin type and many other factors. Best of luck!Dhaval M. Patel Double Board Certified Plastic Surgeon Hoffman Estates Barrington Oakbrook Chicago

Tassos Dionisopoulos, MD · Answer

you've had a terrific result! and best of all you seem pleased wit the result which is the bottom line. your scars look about par for the course at this time period but remember its hard to compare to others because genetics and skin type make important contributions. in terms of what else to do, many of my patients have found that silicone gel scar strips help a lot.

Gary L. Ross, MBChB, FRCS · Answer

Congratulations on your procedure and you look to have a great shape. Your PS will be able to take you through scar management /massage +/- silicone. Everything will continue to improve over time and there is no reason that these scars will not fade.

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