Is this a hypertrophic scar forming? I am 5 weeks po scar revision in my arm lift. (photos)

Question

- the scars went terribly hypertrophic and my wonderful surgeon excised them. I now have the same white line forming again - is this happening again and what can I do to stop it? I'm using Cica-care gel sheets already and massaging rigorously. Would I try hydra cortisone as well?

Sohail Akhtar, MBChB, FRCS(plast) · Answer

Yes it does look like hypertrophic scarring. Be reassured that this will improve significantly the only unknown is how long it will take to improve. Cica care sheets at this stage are very good and I would advice that you continue to use these. I would stay in close contact with your plastic surgeon so that he or she can monitor changes and adjust treatments accordingly.

J. Timothy Katzen, MD, FACS · Answer

Hi Swannytoo, Thank you for your arm questions regarding hypertrophic scarring after an arm lift (brachioplasty) scar revision. I do not know what your arms looked like before your original arm surgery. I do not know what your arm scars looked like before your revision arm surgery. Nonetheless, with the history you provided and the arm pictures you included,  I would suggest laser treatment. I would suggest the Fraxel, V-beam, or erbium YAG laser. These lasers are mentioned in order of my personal preference. You will probably need several treatments.  I would not use cortisone. I would use arm compression and silicone gel sheeting. These modalities have been medically proven in the plastic surgery literature to improve arm scars. Thank you for your questions regarding arm scar revision and what to do with your present arms scars.  If you have any questions regarding an arm lift, arm reduction, brachioplasty, or arm scar revision, please contact my office.  Good luck. Sincerely, Dr. Katzen

Payman Danielpour, MD, FACS · Answer

I highly recommend that you do something different the second time around or you will end up with the scar.  I use Embrace Scar Therapy for all of my patients and they are very satisfied with the appearance of their scars.  It is the only fda approved scar therapy with research and data.  Best of Luck!

Nathan Stewart, MBBS, MS, FRACS · Answer

Two main treatment options are based on silicone.  Sheets work well but are a pain to keep on the area.  If you combine it with a well fitting pressure garment then the compression will not only help the scar but also to keep the silicone sheets in place.  To be effective you need to keep the sheets on the majority of the time.  An alternative is to use silicone gel.  Much easier to use and just regularly apply it. 
If ongoing problems then regular injections of a steroid will help.   Any further excisions will just result in the same process.

Gregory Baum, MD · Answer

Based on your photos, it looks like you are developing hypertrophic scars again. At this point, you should be using silicone sheeting to put pressure on the scars and continue with scar massage. I would also ask your PS about some early steroid injections to the scar in addition to doing the other things above. Some people, unfortunately, are just poor scar formers and will develop hypertrophic scars despite all of these maneuvers. I hope this is helpful to you. Best regards.

Yannis Alexandrides, MD, FACS · Answer

Yes this looks as though this is the beginning of a hypertrophic scar, but it's too soon to say how hypertrophic it will be. It's important to visit your surgeon as they might treat it with an injection of kenalog.

Aldo Guerra, MD · Answer

It appears you're experiencing the beginning of hypertrophic scarring again. I suggest you consider Embrace Scar Defense, at 5 weeks is not too late. Best wishes, Dr ALDO

Joseph Raniere Jr., MD · Answer

Thank you for your question and photos.  You do appear to have early hypertrophic scarring which is common after this type of surgery.  You are doing everything correctly with use of the Cica-care gel sheets and massage.  I would discuss initiating steroid injections with your plastic surgeon.

Gary L. Ross, MBChB, FRCS · Answer

I would concentrate on massage at the moment. Yes the scars are a little thickened but this is usual with arm lifting. Yes silicone helps but not at the expense of massage. I personally wouldn't recommend steroids but best to run through the pros and cons with your PS.

John W. Menard, MD · Answer

Your scars look fairly normal after arm lift procedure.  I would stay in close contact with your surgeon so that he/she can continue to monitor the situation and adjust your treatment options. Good luck!

Is this a hypertrophic scar forming? I am 5 weeks po scar revision in my arm lift. (photos)

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