Breast Augmentation Keloid Removal

Which Incision Position is Best for a Keloid Former in Breast Augmentation?

Doctor Answers 8

Breast augmentation and keloid formation

My first concern about answering this question is that there is a huge difference between forming a hypertrophic scar and forming a keloid.  There are a myriad of modalities to treat and prevent occurence or recurrence of hypertrophic scars.  Preventing keloid formation is much more difficult.  Please consult with your board certified plastic surgeon.

Wishing you all the best,

Tal Raine MD FACS

Chicago Plastic Surgeon
4.5 out of 5 stars 8 reviews

Keloids and breast augmentation

I agree that the decision to have cosmetic surgery in a known-keloid former should not be made lightly, either by the patient or surgeon. Having said that, there are some techniques used in known keloiders to reduce the risk of a keloid developing. For example, injecting steroid medication into the wound edges immediately before closure is one such technique, although it may carry some risk of delayed wound healing. Also, the use of silicone gel sheets for pressure to the scar is quite common. As has been said here by others, select the site that would bother you least if a keloid develops, as I do not think any of the major approaches are any more or less likely than others to lead to keloid scarring.

  • An inframammary keloid may bother you least because it will be covered most of the time either by clothing or by the lower part of the breast, depending on the degree of overhang.
  • A periareolar keloid, if relatively short in thickness, may not be that noticeable in a very dark-skinned patient in comparsion to the normal areola.
  • An axillary keloid could become quite visible in certain clothes, but would keep the symptoms, if present, off the breast. Talk to your surgeon specifically about this concern.

If a keloid develops, therapy can include revising the scar with or without steroid injections, and scar revision accompanied by short course radiation. Obviously, it is not ideal to radiate a breast for a keloid that developed from cosmetic surgery, so bear that in mind.

Good luck.

Tim A. Sayed, MD, FACS
Boca Raton Plastic Surgeon
4.9 out of 5 stars 15 reviews

Placement of breast augmentation incision for keloid former

You will want to choose an incision that can be hidden, such as the fold under the breast or the armpit. You can also ask your surgeon whether a kenalog (steroid) injection into the incision at the time of surgery and silicone sheeting after the dressings are removed are recommended. This is often done to reduce keloid formation in known keloid fotrmers. After your surgery, be vigilant about the development of a keloid and let your surgeon know as soon as you think one is forming. Steroid injections can be done again to slow the formation of scar tissue.

Nia Banks, MD, PhD
Washington Plastic Surgeon
4.0 out of 5 stars 26 reviews

Keloids and breast augmentation

If  you are a true keloid former, I would think twice about having breast surgery.  If on the other hand they hypertrophy, then I would conseider close monitoring and probably inframammary.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

Incisions for keloid patients

The classic advice for keloid formers is that the skin of the breast itself (not the chest wall as in the inframammary crease) and the eyelids are less likely to form keloids.  Additionally, your surgeon can inject steroids into the incision and use various silicone gel preparations to try to prevent keloid formation.  Having said all of this, it is a risk that you are aware of as is your surgeon, and all of your efforts may not prevent a keloid just as birth control may not prevent pregnancy in everyone.  The key is to maintain frequent and good contact with your surgeon so that you can attempt to address problems early.  Good luck!

Eleanor J. Barone, MD
Tampa Plastic Surgeon
4.8 out of 5 stars 4 reviews

Which Incision Position is Best for a Keloid Former in Breast Augmentation?

I inform my patients who have a tendency to keloid to choose the incision site that would least likely bother them if they did end up getting a keloid.  There is no steadfast guarantee that you will not keloid with any of the incisions, so it is best to choose an area that would bother you the least.  I find that the axillary incision tends to have an extremely low incidence of keloid formation in my practice, and I believe that this is because there is no tension on the incision.  Good luck!

Amy T. Bandy, DO, FACS
Newport Beach Plastic Surgeon
4.9 out of 5 stars 104 reviews

Scar locations for breast augmentation

The incisions we usually use for breast augmentation are located in the crease under the breast or around the areola or in the armpit. Occasionally, if saline implants are used it can be placed through the belly button. In my opinion placing the incision in the fold may be the best option for a keloid former.

Breast Augmentation Keloid Removal

It is difficult to say without examining you, but in general I would recommend a inframammary fold incision because if it does keloid it would likely be hidden by the augmented breast.  There are other options that might be better for your specific body (including perhaps not having surgery).  I would discus your concerns for scarring with you board certified plastic surgeon and then they can guide you to the best option for your body and skin type.

Good luck!

Timothy W. King, MD, PhD
Birmingham Plastic Surgeon
5.0 out of 5 stars 1 review

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.