Why Did my Left Nipple Scar the Way It Did and is It a Good Candidate for Revision? (photo)

I had augmentation surgery 18 months ago. The scar on the left nipple is raised and red. I wanted the areola reduced in size on that breast so the surgeon cut all the way around it with only a partial incision on the right breast. I've tried silicon pads, massaging, lotions, etc but it looks like it is here to stay. Questions: Why did it scar that way when the other one didn't? And can it be revised so the scar doesn't bubble up like that again? What kind of revision will give the best result?

Doctor Answers 9

Scarring after areolar reduction

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Periareolar scars from a periareolar lift or areolar reduction are under a lot of stress from the breast pushing out against them, and they are therefore more prone to thicken or widen.

Your scar still appears pink in the photos (and is therefore still immature), and may respond to a series of steroid injections.  Revision of the scar, with placement of a permanent suture placed within the deeper layers of the skin to maintain the diameter of the areola (if this was not tried the first time) may also help.

I would recommend that you discuss potential treatment options with your surgeon, who knows exactly how your original left areolar reduction was performed, and will be better able to guide you regarding the potential risks and benefits of different treatment options.

Good luck.


Houston Plastic Surgeon
5.0 out of 5 stars 29 reviews

Scarring in a periareolar lift.

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Thank you for your question and for your photographs.  Your surgeon did a lovely job. The photographs are quite helpful. 

From what I see here you have a standard breast implant incision on the right side but on the left because the incision goes all the way around the areola you must have had a Periareolar lift or mastopexy on the left side.


 Periareolar mastopexy scars can behave different from standard breast augmentation incisions because they are used to tighten skin.  Tension can sometimes make a scar widened or thicken.  Sometimes the areola can stretch or dilate, sometimes the scar can stretch or expand.

I suspect this is why you are seeing a slightly wider thicker scar.  Discuss your concerns with your plastic surgeon.  18 months out he or she may recommend steroid treatment, steroid tape, or possibly scar revision.  Be sure you know all your options because sometimes scar revision can lead to the same situation.

Best wishes.



Adam Tattelbaum, MD
Washington DC Plastic Surgeon
5.0 out of 5 stars 115 reviews


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Hello sorry to hear that your scarring is not what you expected. It is normal for our body to heal in different ways, specially breasts. There is no easy explanation, there is a lot of different things to use for scar therapy, scar guard, Hybrisil and chemo therapy right after surgery.

Stuart B. Kincaid, MD, FACS (in memoriam)
Beverly Hills Plastic Surgeon

Breast Enhancement

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It likely happened because of the tension of the implant on the skin aka the scar. Now that the skin has stretched and the tension is removed a surgical revision should do well, you can try non surgical options though like steroids

Scarring after an Areola reduction, can it be fixed?

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It appears that you had a peri-areola reduction/lift. If your main concern is the raised appearance of the scar and its color, I believe that a scar revision may help at this point if you have tried all other modalities. If you are upset about the shape of the areola this is unfortunately a result of that type of surgery and is almost unavoidable.

Jonathan Weiler, MD
Baton Rouge Plastic Surgeon
4.9 out of 5 stars 93 reviews

Peri-areolar scars

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When a peri-areolar breast lift or areolar reduction is performed, the incision is closed under some tension, which increases the risk of hypertrophic scarring, which you have.  Now that all of the swelling and tension have long since resolved, you are a reasonable candidate for a scar revision.  Following this, the scar should be carefully monitored, and you should begin using silicone gel sheeting after 2-3 weeks.  It there is any sign of recurrent hypertrophic scarring, an intralesional injection of steroids can be very helpful.

Scarring around the areola.

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There is a difference in scarring between the two breasts because of different surgery. The scar on the left is red and slightly raid which means it is still active and healing has not completed. In general, any scaring after two years from surgery is likely to be permanent. So I would give some more time before considering scar revision.

Moneer Jaibaji, MD
San Diego Plastic Surgeon

Scar around areola

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The scar around the areola is still red. You have to give it time to settle down and this may take a year os longer.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Areolar scarring

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Basically, you had additional surgery on the left breast so there is more scarring on that side. The scar is under tension in an augmentation with an areolar reduction and I also believe that you had a lift on that side. You could undergo scar revision but, first, I would recommend a course of steroid injections.

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