Best scar protocol?

I am wondering, which scar protocol has been clinically proven to work best for lift scars? What do you all recommend? If $$$ was no issue, what would "the best" be?

Doctor Answers 9


I appreciate your question.

I perform a liposuction breast lift that removes tissue from the areas you don't want such as near the armpit and the lower portion hanging near your stomach. Once I use this to shape the breast I then remove the skin to tighten the breast and create a better shape with nice cleavage. Since I perform this less invasively the recovery time is faster. The size would depend on the proportion with your body versus going for a cup size.

The best way to assess and give true advice would be an in-person exam.  Please see a board-certified plastic surgeon that specializes in aesthetic plastic surgery.


Best of luck!


Dr. Schwartz

Board Certified Plastic Surgeon



Beverly Hills Plastic Surgeon
5.0 out of 5 stars 91 reviews

Preferred Breast Lift Incision

A mastopexy or breast lift operation is designed to improve the shape and position of the breast without reducing their size. It is used for breasts which sag or droop (ptosis). Sagging of the breasts may occur with normal development for some women, or as part of the aging process. Pregnancy, breast-feeding and weight loss are other conditions which increase breast ptosis. Some patients will have a better shape to their breast such as increased superior fullness if an implant is used at the time of mastopexy. The procedure can also be combined with a minor breast reduction to reduce the breast width if desired. The surgery will create an elevated, more youthful breast contour. Also, the procedure will create nipple and areolae of the desired size and at the correct height.

I prefer to use a #shortscar technique, #LollipopScar or #DonutLift” rather than the majority of surgeons in the United States that use an anchor pattern lift which involve more significant scarring.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 109 reviews

Best scar protocol

Best Scar Management is important to minimize or completely hide from view, the telltale signs of your surgery—namely, scars. Both you and your surgeon want you to have the most minimal scarring possible. There are many possible causes for scars that are enlarged or not healing well. Unsightly scars are most commonly due to genetics, underlying medical conditions, or improper scar/wound care. The last part is very important and patients can make a noticeable difference in their scars’ appearance by following best scar management practices. Here are some simple tips.

Scar Management tips:

  1. Minimize tension on the scar. Steri-Strips and/or surgical tape are often placed in non-hair bearing areas at the time of surgery to minimize tension and keep pressure over the scar.  This minimizes the  stress that  can pull the scar apart (dehiscence) creating a wound and  delaying healing time, and can make the scar wider, or more “ropy”. In the first few weeks after surgery, I recommend the use of Embrace Scar Therapy which is an adherent silicone sheeting pre-stretched when applied so as to offload tension on the scar.
  2. Keep your incision site/scar clean to prevent infection. Follow your surgeon’s wound care instructions to the letter with out modification. Never apply different products then recommended without first discussing them with your surgeon. This is especially important during the first few weeks. If there are any signs of infection, contact your surgeon’s office right away and/or see your doctor or his nurse immediately. Typical signs of infection may include redness outside the immediate incision site, asymmetric swelling, and drainage, of pus, fever, chills, and “feeling sick”.
  3. Protect your scars from the sun. Staying out of the sun is the best advice. Minimal exposure to sunlight is prevents hyperpigmentation (permanently turning brown) and other problems that can make the scar more noticeable. Sunscreen, at least 30 SPF and an overlying make camouflage make up additionally protects the scar from the suns harmful rays. This advice is especially important the first year following your surgery.
  4. Use specific scar maturation products recommended by your surgeon. Patients seem to have their own opinions on this touting everything from Pure Vit E, Coco butter, to Aloe Vera, etc but most have minimal benefit other than keeping the scar hydrated. Although hydration is important there are better, scientifically studied products with greater efficacy. Most of the scientific articles written about this subject indicate that topical silicone gel or silicone sheets work the best. The best product available in my opinion is the Embrace Scar Therapy System by Neodyne BioSciences, Inc. available in many surgeons’ offices. Essentially this is an adherent silicone sheeting pre-stretched when applied so as to offload tension on the scar. For areas that are not applicable for this product (e.g. smaller areas or on the face), I prefer BioCorneum or Kelo-Cote products There are a lot of products to choose from, but silicone should be one of the key ingredients. Although Mederma, an onion extract derivative active ingredient rather than mainly silicone based may help, primarily silicone based products are better and many also contain other ingredients that may be synergistic (hydrocortisone or other steroid, Vitamin E, Sunscreen, etc).. If the reader has problems obtaining these they can call my office. Patient compliance is also critical – use often and according to directions or it will not work optimally. NEVER apply products without first discussing them with your surgeon.
  5. Monitor to make sure your scar is progressing optimally. Keep your scheduled follow-up appointments with your surgeon to verify that your scars are maturing as expected.  Occasionally if indicated you may need a topical steroid preparation or even a series of  injections (5-FU and/or Steroids) or laser treatments  to treat or  prevent scar hypertrophy or keloid formation (red raised scars), or other topical medicines to treat post inflammatory hyperpigmentation (brown scars) with prescription creams and possible laser treatments.

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 154 reviews

Best scar protocol

The gold standard for reduction in the appearance of acne scars is CO2RE by Syneron-Candela for Fitzpatrick Skin types I-III.  Microneedling is an excellent options for all skin types and can be customized for each patient's unique needs.  Multiple treatments are typically required, however downtime and discomfort is minimal.

Another great option is VI Peels and/or VI Peel Precision Plus for scars and pigmentation issues on all skin types.

Sometimes patients with scars benefit from a combination of treatments augmented by injections with fillers. There are different types of fillers and the physician can customize the procedure based on the unique need of the patient.

Hope this helps.  Good luck.

David Shafer, MD
New York Plastic Surgeon
4.9 out of 5 stars 75 reviews

Scar Therapy

There are many scar treatments, but only Embrace has been researched and in fact has has level 1 scientific evidence to show it's benefit. Tension on the incision is what generates the thickening of may scars, and different people respond of course in different ways.  If you can commit to the therapy, it is worth doing. I'm happy with it in my practice. 

John LoMonaco, MD, FACS
Houston Plastic Surgeon
5.0 out of 5 stars 270 reviews

Scar management protocol utilizing bioCorneum and embrace Active Scar Defense

Thank you for your question.  "Scars" are really just the names we give to incisions that heal after surgery.  The word "scar",in general, often suggests a bad connotation.  A significant component of "how" a scar heals has to do with each person's genetics; however, there are other factors that can be optimized that we know from science that can improve scar formation.  We have know for many years that silicone is good for scars, and there are many different types and different formulations of silicone.  Excess tension along a healing scar is another factor that can portend a more thickened or widened scar after surgery.  I developed a "1-2-3 approach" to scar management that involves cutting-edge science.  At the time of surgery, I utilize Prineo Dermabond, which is an "updated" skin glue with a matrix that adds strength to the incisions at the time of surgery. I think this is better than traditional  "steri strips".  This "tape" usually stays on for 2-3 weeks. At this time, I usually add embrace Active Scar Defense which is a "tension-unloading" silicone taping system that provides silicone sheeting "cover" to the incisions and tension-unloading at the same time.  This can be used for 6-8 weeks.  This is really one of the most exciting advances, in my opinion, to come along in scar management in the last few years.  The final step I employ is to use bioCorneum scar gel to the incisions.  This is a silicone gel "quick drying" formulation that you use twice a day that dries onto the incisions and further promotes optimal healing with silicone.  For more details, about this protocol, I have written about it in my blog at the link below.  I hope this helps!

James F. Boynton, MD, FACS
Houston Plastic Surgeon
4.8 out of 5 stars 42 reviews


The only product available on the market that has level 1 scientific evidence to work is Embrace scar therapy.  It begins 1-2 weeks after surgery and continues for 8 weeks.  It is a biomechanical dressing that takes tension off the suture line.  It is made by a company called Neodyne.  It was introduced 4 years ago and was developed at Stanford University.  You can find more information on line.

Hope this helps.

Dr. Ali Mosharrafa

Ali Mosharrafa, MD
Phoenix Plastic Surgeon
4.9 out of 5 stars 14 reviews

Best scar protocol?

Your plastic surgeon will be your best resource when it comes to advice regarding incision line care. You may find that every surgeon has his/her preferences. Generally speaking, the use of silicone-based products ( gel or sheeting) may be helpful. Massage and or the use of tape  may also be helpful. 
Best wishes; hopefully you will be very pleased with the outcome of the procedure performed.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,488 reviews

Best scars after breast surgery

  • I do a number of things to try to get great scars. One of the most important includes the surgical techniques I use to minimize tension and tissue trauma. 
  • I think that taping for a few weeks to minimize tension followed by silicone strips and scar massage can make a big difference.
  • I have developed a few different cream formulas with a compounding pharmacist to improve scars and minimize thickening and pigmentation.
  • Should scars develop there are also things such as IPL or laser as well as injections that can improve them.
  • Despite all this, at the end of the day, genetics play a part and some people will form better scars than others.
  • Dr Rodger Shortt is a plastic surgeon in Oakville.  He strives to be the best plastic surgeon and is one of the few plastic surgeons in Canada with a top 5-star rating on Realself, RateMD, and Ontario Doctor Review.  He is an Assistant Clinical Professor and the Director of Cosmetic Surgery Training for McMaster University.  He serves patients from the GTA including Toronto, Oakville, Mississauga, Georgetown, Brampton, Burlington, Milton, and Hamilton.

Rodger Shortt, FRCSC
Toronto Plastic Surgeon
4.9 out of 5 stars 65 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.