What procedures or products can be used for old breast reduction scars? (Photos)

Our treatments use combination therapy to improve the epidermis and dermis. We see atrophic and hypertrophic scars, as well as scars that have hypo and hyperpigmentation. Our main concern is rebuilding collagen and that is why we use a HIDEF protocol that includes combination therapy. Morpheus 8, scar subcision, fibrous release, fractional laser, CO2 laser, Thulium laser, PDL Vbeam laser, and fractional resurfacing can be used in addition to TCA Cross and chemical peels to further improve skin. Patients should start Melarase AM and Melarase PM for active hyperpigmentation. Always begin with a consultation to discuss the best treatment options for your type of skin. .

Best,
Dr. Karamanoukian
Realself100 Surgeon

Thank you for sharing your photos and details. I understand your concern—scars after breast reduction, especially in patients prone to keloids, can be a source of frustration even years after surgery.

Here are the main strategies to improve old breast reduction scars:

Topical Treatments:

Silicone Sheets or Gels: These are often the first-line approach for old scars. They can help flatten, soften, and lighten hyperpigmented areas over time.

Scar Creams with Ingredients Like Vitamin C or Centella Asiatica: Can support collagen remodeling and improve texture.

Injections:

Steroid Injections: Effective for raised, thickened, or keloid-prone scars. These can reduce size, redness, and discomfort.

Combination with 5-FU (if needed): Sometimes used for stubborn keloid scars.

Laser Treatments:

Fractional CO₂ or Pulsed Dye Laser (PDL): Can improve texture, pigmentation, and overall appearance of scars.

Multiple sessions are often needed for optimal results.

Surgical Scar Revision:

In some cases, excision of the old scar followed by meticulous closure may provide the best cosmetic outcome.

This is usually reserved for severe or bothersome scars and should be combined with post-op scar management to reduce recurrence.

Pressure or Silicone Therapy Post-Revision:

Especially important for patients prone to keloids to prevent recurrence after any intervention.

Given your history of keloid formation, a multi-modal approach often works best—combining laser, topical therapy, and possibly targeted injections.