African American Breast Augmentation, Lift, or Both? (photo)

I am the usual suspect, AA, mom of two, breastfed both. The problem is of course I keloid. I have a keloid on my foot from a botched bunioectomy done 16 years ago in the military. I am terrified that my boobs will look a mess. I live in Las Vegas, NV where most PS are hesitant to work on us. I've had 5 consults with varying opinions. The latest he stated I could get away with a breast augmentation, silicone, dual plane. Help, I don't know what to do!

Doctor Answers 21

Augmentation versus lift for keloid formation

Hello. The answer to the question you have regarding getting a lift as oppose to just a normal augmentation depends on the look you are hoping to get. If you are hoping to simply make your breasts larger while keeping the natural look then a normal augmentation would most likely be the best option for you. If you like the higher look that is more full at the top then a lift would most likely be the best way to go. Regarding keloid formation, if you do truly form keloids you have to be ready and expect them to form. The best advice I can give would be that a lift involves much more scaring so maybe it should be avoided.

Jaime Perez, MD
Breast Augmentation Specialist
Plastic Surgery Center of Tampa

Tampa Plastic Surgeon
4.8 out of 5 stars 67 reviews

Circumareola incision for minimal scar

You are a perfect candidate for a new technique called Breast Augmentation with Mini Ultimate Breast Lift.  Using only a circumareola incision it is possible to lift your breast tissue higher on the chest wall, more medial to increase your cleavage and reshape your breast to increase upper pole fullness and projection.  This avoids the ugly vertical scars of the lollipop or boat anchor shaped incisions.  It is impossible to predict what type of scar will occur but the circumareola incision will minimize scars.

Best Wishes,

Gary Horndeski, M.D.

Gary M. Horndeski, MD
Texas Plastic Surgeon
4.7 out of 5 stars 208 reviews

Breast Augmentation question - African American

First determine if your scars are truly keloids and could good surgical technique avoid wide scars.  The smallest scar procedure is the one you have already have an opinion on:  dual plane breast augmentation.  The biggest scar procedure would be a breast lift. 

Best Wishes!!

African American Breast Augmentation, Lift, or Both?

If truly a KELOIDER than you should NOT have a lifting operation. If you ca not let well enough alone than try JUST implants. With the understanding you could become encapsulated. 

Keloids and breast lifts: what to do?

First, many people think any bad scar is a keloid.  Keloids are a very specific type of scar, and your foot scar might just be a different kind of bad scar, not necessarily a true keloid scar.  

If you have pierced ears and no keloid scars on your ears, then there is also a chance that scars in other body areas won't form keloids either.

Thank you for the photos.  You appear to be a borderline for needing a lift. You may find that  you are happy with just implants. You can always add a lift down the road if the implants alone don't make you happy.  Best wishes!

Carmen Kavali, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 38 reviews

Keloids and breast augmentation/mastopexy

Scars can be very unpredictable, but poor scarring on your foot does not necessarily mean that you will have poor scarring on your breasts. You can always opt for a breast augmentation alone, but you need to know that the results may not look as good as the photos that you might be comparing them to of other patients that are starting with a tighter breast skin envelope. In the end, you will just need to decide if improving the shape of your breasts with a breast lift is worth the risk of poor scarring. I think that your chances of having poor scarring on your breasts is probably lower than you expect though.

Wm. Todd Stoeckel, MD
Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 76 reviews

Scarring and breast surgery

Thanks for your question and pictures.  Scarring on the foot and breast can be quite different, as I am sure you have found out with your previous consultations.  Breasts generally heal well, but many factors play into scar formation including genetics.  There is no way to guarantee that you will not form a keloid scar.  It is very unlikely, but not impossible.  You will have to weigh the risks and benefits and determine how you would like to proceed.  I would say that a breast augmentation alone is unlikely to give you the look you desire.  Good luck!

Naveen Setty, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 58 reviews


Scarring can be unpredictable. I would advise you to stick to the pure augmentation without any lift if you are truely a keloid former. 

Norman Bakshandeh, MD, FACS
New York Plastic Surgeon
4.9 out of 5 stars 14 reviews

African American Breast Augmentation, Lift, or Both?

Although the breast skin rarely gets true keloids, I have seen it happen in all races, so you definitely need to be cautious. I have also seen scar hypertrophy in all races. It is definitely genetic. One option you have is to have the surgeon make a 1cm incision at the areolar margin and another lower on the breast and simply sew them up. If they make bad scars, at least it will be quite limited. If not you can proceed with the surgery confident of the scar quality.

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 24 reviews

African American Breast Lift and Augmentation


I will assure you that you will not develop a keloid from an incision placed on your breast, and it is unlikely that you will develop a hypertrophic scar (a thick kind of scar) either.  The skin of the breast is a privileged area in all races, where these sort of noticeable, symptomatic scars don't usually form. That is why the risk/benefit ratio of a breast lift stays the same regardless of race.

You will not look good with either an aggressive dual plane or subglandular placement of an implant.  In the end you will still be droopy, and probably bigger than you want to be due to the inappropriately large implant that the surgeon feels you need to 'lift' you.

The key to minimizing scars in all skin types is in the technical aspects of the surgery: meticulous treatment of skin edges, keeping the most amount of  blood circulation in all the tissues to be moved and pulled, and precise closure of the skin edges for rapid healing and minimizing bacterial colonization of the incisions.  In other words, you want someone who is an expert in the field of breast lifts, reductions and revisions.  This kind  of surgeon would not hesitate to do the right thing for you just because of your skin type.

Best of luck!

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 78 reviews

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.