Red scars after 7 months (Photo)

Wound healing post cosmetic surgery is a dynamic situation.  By that I mean, it takes what it takes. Incisions made in Langer's lines, which are lines in the human body that have minimal or no tension on them, can heal in a week or less.  When the incision is not placed in these tension free lines and when the dermis (the underside of the skin) is thick and there is constant movement, some of these scars can take months and even years to heal. Of course, there is the genetic component which is normally controlled through the immune system.  Some individuals form little to no scar.  Others form very exaggerated scars.  And then, of course, there is the keloid which is the very, very thick and unsightly type of scarring.Your scar is red because it is dynamic.  It hasn't healed yet.  When it does, it will turn white.  If you were my patient, I would recommend continued pressure on the scar such as the silicone tape you are presently using.  Your red scar is actually a factory producing collagen and wound healing cells called fibroblasts and myofibroblasts.  Keep the tension off the scar by wearing a bra that has a smooth bottom and no underwire as that will push on the breast chest junction causing even more tension on your scar, especially during walking and exercising.  Massaging of scars is an outstanding idea once the scar has matured because it helps the new collagen to lie smoothly instead of having elevations and depressions.  Massaging a red scar will disrupt the factory producing the new wound healing cells and also will disrupt the laying down of collagen leading to a definite slowing of the wound healing.  At this point, you need to reconnect with your plastic surgeon to be sure that you are doing everything correctly to ensure a speedy maturation of your breast lift scarring.

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

Scars can be challenging, especially breast scars. I don't think you have an unusual problem to worry about. As you are experiencing, scars can take on a course of increasing thickness and redness before they flatten and fade. It can be very annoying for the patient and surgeon. Taping early on with paper tape and then silicone tape can help decrease the intensity. Microneedling at around 7 weeks may help soften the scars. Dilute steroid injection can also help soften the scars but there is a risk for too much thinning of the tissue. The scars typically get better with time but it could take years.

Your scars have not matured yet it usually takes about one year or more to completely heal just be patient and continue to follow up with your PS.

If the scar is still red it means that it has not matured yet. Continue with your taping and make sure to massage the scar. It can take up to a year or even longer for the final scar to appear. I'd suggest booking an appointment with your surgeon to be examined if you are really concerned and want to be reassured. Best of luck! 

Hi New_lift,

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, MD, MHA, MS

Certified, American Board of Plastic Surgery

Member, American Society of Plastic Surgery

Member, American Society of Aesthetic Plastic Surgery

Red scars are usually the sign of an "immature" scar.  It can usually take up to a year and sometimes longer for scars to "mature."  A mature scar appears white and is usually soft and pliable.  Your scars do appear immature still.
Scar care involves three main focus areas: sun protection, massage/pressure, and silicone/scar cream.  
Ultraviolet light (UVL) damages the skin.  This is true with scars as well.  In particular, UVL can cause the healing scar to retain color.  Using a sunscreen with spf 30 or higher and/or keeping the area covered can help prevent this.
Scars mature by building and organizing collagen.  Thickened scars produce an overabundance of unorganized collagen.  As a scar matures, the collagen becomes more organized, however, it never gets back to its "pre-injury" state.  Massage and/or pressure applied to the scar can help  with this process.
Silicone strips have been shown to help hydrate scars and are effective in helping form flatter, softer results.  It has been used successfully along with compression in burn patients for many years.  Silicone strips should be worn as much as possible for the duration of your healing.  
Despite these treatments, some patients still produce red or thickened scars.  Adjunct treatments can include steroid injections, intense pulsed light (IPL) or fractionated laser treatments, and even surgical scar revision.
I would continue your current scar care regimen and follow up with your plastic surgeon to see if he/she would suggest any adjunct treatment at this time.