Hypertrophic scar after C section, planning BA (Photo)

Question

I has C section 8 months ago, and my scar became hypertrophic, i want to do breas augmentation soon. I have visited around 8 doctors, but they all tell me different things regarding where should i make an incision: around the areola or under the breast. Which incision location is less prone to hypertrophic scarring? I am 29 y.o, asian race

Daniel Barrett, MD · Answer

Dear arua,
we specialize in minimal scars. Its starts with a peri-areolar incision that hides the scar at the border of the areola. Next, I close my incisions in 5 layers and take stitches out week one and week two. I don't recommend absorbable sutures because they cause inflammation that worsens scars. Then we tape your incisions once a week for 6 weeks. Lastly we start you on a 3 month topical scar management protocol with a scar gel thats FDA approved. 
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Brian K. Reedy, MD · Answer

Thanks for your question! I would suggest an inframammary incision. We have lots of tricks up our sleeves to help with scarring so hopefully we can avoid a hypertrophic scar this time around. Best of luck!

Derek Fletcher, MD · Answer

The safest incision for breast augmentation in terms of future implant complications is the breast crease (inframammary fold) incision. This incision is positioned to protect the implant from contamination by bacteria. The nipple and areola constantly shed bacteria. Peer reviewed studies looking at complication rates for capsular contracture and implant infection are higher for incision around the areola and through the arm pit.

Connie Hiers, MD, FACS · Answer

Both will be a risk to develop a hypertrophic scar, but it may be less noticeable underneath. Scar products and steroid injections can be helpful after surgery.  The axillary incision is least likely to form a hypertrophic scar, but it does carry additional risks and is harder to reuse in the future.

Camille Cash, MD · Answer

The most common incision for breast augmentation for me is the inframammary fold.  This carries several benefits such as lower capsular contracture rate, least disruption of tissues, and the scars tend to heal very well.  I've included a video that I hope you find helpful.

Brooke R. Seckel, MD, FACS (retired) · Answer

I see your scar is red. Try Mepitac tape-can buy on Amazoin. Leave on C section scar 5 days before changing. You may need to use for a few months to improve C section scar.

Hypertrophic scarring is very rare after breast augmentation in my experience. Today to get the best result you should read about the no touch technique. The no touch technique with incision under breast has the lowest risk for capsular contracture

Hypertrophic scar after C section, planning BA (Photo)

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