Will my Incision Site Scars Be Much Worse After a Breast Implant Revision?

Question

I had a breast augmentation about 2 months ago with 300cc salines and they are too big so I am planning on having a revision with 250 cc silicone. I went through the aereola and it has been healing very well. I was wondering if I went through that same incision site again, would the scar be alot worse? I reallly do not want my implants to be noticable. Would I be better off going with the transaxillary incision? Does that incision heal well and is it noticable?

Richard H. Tholen, MD, FACS · Answer

As others have stated, you still have some softening, settling, and swelling reduction to occur over the next several months. But even if you are convinced that NOW is the time to re-operate, there are a couple of things to consider:

	     First, your scar has not completely matured and re-operating through the same incision could contribute to slightly more visible scarring (even though the old scar is removed and a "new" scar is created in the same location). This is because of the residual edema and induration (the firmness you feel around your scar) that makes suturing more difficult and healing perhaps slightly more problematic. Waiting 6 months allows your scars to soften and mature enough so that excising the old scar can yield as good a result as you now have.

	     Secondly, a 50 cc change may seem like a reasonable decrease, but 50 cc is the same volume as 3 tablespoons and 1 teaspoon of liquid. Put that amount in a glass and see if you think that much less over an entire breast's volume will really be a noticeable drop. To look at this another way, 50cc is roughly equivalent to one-fifth of a cup size. Do you really want to undergo the (slight) risks, the not-so-slight costs, and your concerns about the scar for a change that will likely not even be visible (except in your mind's eye!)?

	Finally, a new incision makes no sense! You and your surgeon selected what you both felt was the "best" choice for your surgery, though other surgeons and patients may differ. Why add a second pair of incisions and scars?

Young R. Cho, MD, PhD · Answer

Thank you for your question. Going through the same incision is a great idea so you are not creating a new scar.  Post-operatively, breast incisions can be managed using a multimodal approach:1) Scar massage - starting as soon as the surgical dressings come off and the incisions are sealed2) Silicone sheets or scar gels for about six months to year3) Embrace - a tension reducing dressing for the first 2 months4) Fractionated lasers to help blend the scar into the background - done as a series, starting about 4 weeks after surgery and repeated every four weeks for six months.5) Sunscreen to prevent the scars from darkening

Lewis Albert Andres, MD · Answer

Hello! Thank you for the question!  The typical incision used for breast augmentation are: inframammary (in the fold beneath your breast), periareolar (at the border of the areola), axillary (within the armpit crease), and TUBA (through the umbilicus). Incision placement will do a lot with your preference, surgeon comfort level with that approach, and the type of implant - silicone implants will be difficult to place within certain access incisions. Breast augmentation scars are well concealed and are very discrete. They should not be visible within clothing, and likely hidden without clothing. If your concern is the visibility without garments, you should consider remote access incisions such as in the armpit. However, these other incisions heal very well on the breast and often times inconspicuous.  I do not expect your incisions to be any worse, in fact, if the previous scar is removed, it may even be better.  It is common for scars to fully mature for up to a year. In the meantime, there are a few things that may help to ameliorate your incision/scar. The most proven (as well as cheapest) modality is simple scar massage. Applying pressure and massaging the well-healed scar has been shown to improve the appearance as it breaks up the scar tissue, hopefully producing the finest scar as possible. Other things that have been shown to add some benefit, albeit controversial, are silicone sheets, hydration, and topical steroids. In addition, avoidance of direct sunlight to the incision will significantly help the appearance as they tend to discolor with UV light during the healing process. If unsightly scars are still present after approximately a year's time, other things that your surgeon may consider are intralesional steroid injections, laser, or just surgical revision of the scar itself.Consult with a plastic surgeon your goals, concerns, and expectations. Certainly incisions should be considered, but should not limit your overall result by hindering visualization and access to your surgeon, and what produces the best results in his/her hands.Hope that this helps! Best wishes!

Richard Baxter, MD · Answer

When a new incision is made through an existing scar, it usually heals just as well if not better. You are not planning to make much of a size change though and it is very early in your recovery so I would advise waiting a few months more and then make sure it is what you want.

Otto Joseph Placik, MD · Answer

Waiting a few more months before making your decision will possibly save you some worrying.  Your breast tissue may be swollen still and the implants may settle more.  If you do plan to revise the implant size, stay with the same incision site.  Going thru the armpit or thru the belly button may cause the breasts to be uneven.  Nipple placement is the most accurate.  If you already have scarring, it will not be too much more noticabe depending on the surgeon, smoking and tanning.

Will my Incision Site Scars Be Much Worse After a Breast Implant Revision?

Answers (10)

Answer: Scars usually good after revision

Answer: Scars usually good after revision

Answer: Deciding to downgrade implants after 2 months is not realistic.

Answer: Deciding to downgrade implants after 2 months is not realistic.

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Everything you need to know about Breast Implant Revision

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Will my Incision Site Scars Be Much Worse After a Breast Implant Revision?

Answers (10)

Answer: Scars usually good after revision

Answer: Scars usually good after revision

Answer: Deciding to downgrade implants after 2 months is not realistic.

Answer: Deciding to downgrade implants after 2 months is not realistic.

Browse related questions

Recommended reading

Everything you need to know about Breast Implant Revision

Our mission is to create a world where every investment in modern beauty is Worth It.