Is this is a Keloid or a hypertrophic scar? 2 months post breast reduction. (photos)

Scars run the spectrum from nice, flat, thin scars to slightly thicker (hypertrophic) to very thick and spilling beyond the edge of the incision (keloid).  Based on your pictures, it appears that you have normal to slightly hypertrophic scars.  It takes about a year to a year and a half for a scar to fully mature so you still have time to modify your scars.  There are a number of scar treatments available.  I'm sure your doctor has a favorite and I would suggest that you ask him what he recommends.  Besides topical creams/ointments/etc., there is also the option of injecting small amounts of steroids into the scar to reduce the overproduction of collagen which is the main component of scars.  It would also help with itching which can sometimes happen as incisions heal.  Again, it would be a good idea to discuss this with your plastic surgeon.

Keloid scars are characterized by their growth potential and increased degree of inflammation within the skin. Unlike non-inflamed scars, keloids have the potential for growth beyond the original footprint of injury. Our office specializes in the management of keloids, whether single or multiple, using a combination platform that includes lasers, RF, scar modulation, Parke-Davis Scar Protocols, and injection therapy. Some keloids will require surgical intervention as an initial step for treatment.
Best,
Dr. Raffy Karamanoukian
Realself 100 Surgeon

Hi there,

This is an interesting question: Keloid vs hypertrophic scar.  Well, keloids usually develop after 6 months and should grow beyond the original site of injury or scar.  They happen in patients with a history of keloid scarring, a family history of keloids, and in specific sites prone to keloid.  A hypertrophic scar on the other hand occurs soon after surgery, remains within the confines of the injury/scar, and one does not have to have any history of previous hypertrophic scarring.

I think the difference is important as a keloid will progress significantly and enlarge, thicken and become painful.  A hypertrophic scar should settle over the next few months, resolve, thin and get softer.

My advice to you is request a review with your surgeon.  He should be eager to treat this issue.  Personally, I would offer some steroid injections and other scar management techniques found on my website to encourage scar maturation.

Treat this early to minimize poor outcomes and need for future revision surgery.
Good luck.

Hello and thank you for your excellent question. In general, a keloid scar extends BEYOND the edges of the original incision, whereas a hypertrophic scar grows ABOVE the scar. Based on your photo, you appear to have a hypertrophic scar, and not a keloid. Regardless, I suggest that you follow up with your surgeon to start having some type of therapy (e.g., silicone sheeting, steroid injections). If you have any questions, call our office for assistance. Good luck!
Best,

Jon Ver Halen, MD FACS

Harvard educated plastic surgeon

Texas “Top Doc”

Ahh, this is a good ! Thank you for the question and the photos. You are a bout 3 months post operative from your breast reduction and your scars are pink. This is normal at this stage of healing. Now, lets get into definitions.   A keloid is an abnormal proliferation of scar tissue that forms at the site of cutaneous injury (eg, on the site of a surgical incision or trauma); it does not regress and grows beyond the original margins of the scar. The key here is that it grows BEYOND the original margins of the scar. If the scar is thickened and raised and does not extend beyond the original margins of the scar, it is considered a hypertrophic scar. At this stage, I would not classify your scar as hypertrophic. And it certainly is not a keloid. We typically see keloids more often in African Americans.  Speak with your surgeon about this. He or she may recommend silicone sheeting which is,so far , the only modality that has been shown to appear the appearance of scars. The natural progression of scarring that you can anticipate is that they will flatten and fade to your skin tone with time. It is important to protect from the sun, which for breast reductions scars is usually not an issue. I hope this little treatise on scar classification is helpful.