Why do incisions scars stretch? Can anything be done to prevent it? (Photo)

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

Thank you for your question and photos! To avoid scars from widening, you should wear a compression bra and avoid stretching your upper body, which will allow for your scars to heal appropriately. The less tension you put on your incisions while they are healing is best for aesthetic results. Best of luck!

Thanks for your question! It looks like there is just a lot of tension pulling in that area from multiple surgeries. I would suggest allowing your body time to heal and then maybe seeking out some sort of tattooing to help give your areola a better appearance. I think that is a much better alternative rather than a 4th surgery. Good luck!

Dear Sunshine180,
for scars, I close all of my incisions in 5 layers and do not use absorbable sutures because they cause inflammation and worse scarring. I tape all of my incisions in the office visits once a week for six weeks after surgery to improve the appearance. After taping, I start my patients on a scar gel therapy for 3 months that they have to put on their incisions twice daily.You should discuss your concerns with your plastic surgeon as different surgeons have different approaches in scar management.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Hello @Sunshine180, thank you for your question. Keep in mind that scar stretching can occur. In breast reduction surgery, the skin is under some degree of tension. The reasons why scars stretch are multifactorial, surgical technique, the direction of the tension, individual skin characteristics, and genetic factors that affect healing. In terms of prevention, it is important to follow your plastic surgeon recommendations and follow post surgical recommendations for proper wound care and support bra. Best wishes! Alan Gonzalez MD, FACS. American Society of Plastic Surgery Member (ASPS), International Federation for Adipose Therapeutics and Science Member (IFATS), American Society of Plastic Surgery Member (ASPS), Colombian Society of Plastic Surgery Member (SCCP).

Incision scars can stretch for several reasons, and understanding these factors can help in managing and preventing excessive scar stretching:

1.) Tension: Scars that form in areas where there is significant tension or movement of the skin are more prone to stretching. When the skin is stretched, the scar tissue can also become elongated, leading to a stretched appearance.

2.) Healing Process: During the healing process, the body forms scar tissue to repair the wound. Initially, the scar tissue is more pliable and prone to stretching. As the scar matures, it becomes firmer and less likely to stretch. However, during the early stages of healing, scar stretching can occur if the skin is subjected to tension.

3.) Genetics: Some individuals are genetically predisposed to forming scars that are more prone to stretching. Factors like skin type, pigmentation, and collagen production can influence scar formation and how they respond to stretching.

4.) Excessive Movement: If the incision site is subject to excessive movement or stretching, such as bending, twisting, or repetitive motion, it can lead to increased tension on the scar tissue and cause it to stretch.

5.) Inadequate Healing: Poor wound healing can lead to scar stretching. Factors like infection, poor blood circulation, or improper wound care can affect the healing process and contribute to scar stretching.

6.) Scar Type: Different types of scars, such as hypertrophic scars or keloids, are more prone to stretching due to their unique characteristics and the way they form.

To prevent excessive scar stretching, consider the following steps:

1.) Follow Postoperative Care Instructions: After surgery or injury, follow your healthcare provider's instructions for wound care and scar management. This may involve keeping the wound clean, using ointments or dressings, and avoiding activities that could put tension on the incision.

2.) Use Silicone Sheets or Gel: Silicone sheets or gels can help maintain moisture and reduce tension on the scar tissue, aiding in preventing stretching.

3.) Massage: Gentle massaging of the scar tissue can promote blood circulation and collagen remodeling, potentially reducing the risk of excessive stretching.

4.) Avoid Excessive Sun Exposure: Protect the healing scar from the sun, as UV radiation can slow down the healing process and increase the risk of scar stretching.

5.) Use Scar-Reducing Products: There are over-the-counter and prescription products designed to help minimize scar formation and stretching. These products often contain ingredients that support healthy collagen production.

6.) Physical Therapy: If the scar is in an area prone to movement, physical therapy or rehabilitation exercises can help gradually strengthen the area and reduce the risk of scar stretching.

7.) Consult a Healthcare Professional: If you're concerned about scar stretching or if you notice any unusual changes in the scar, consult your healthcare provider or a dermatologist. They can provide personalized recommendations and interventions based on your specific situation.

Remember that complete prevention of scar stretching may not always be possible, but taking proactive steps can significantly improve the appearance and quality of the scar over time.

There are several factors that go into how scars heal. Your skin elasticity as you pointed out is one of them. Tension on the incision is another. Genetic influences can also factor in. There are surgical techniques that can improve the chances of favorable scarring. Scar creams, silicone sheeting and other treatments can also be used post surgery to improve the appearance of scars.

Scars stretch from the weight of the breast that pulls on them. You are large enough that you need to wear a good supporting bra. Micro-needling can be helpful for the scars.