Breast reduction t-junction scars. Any suggestions/ (photos)

Plastic surgery scars require attention after surgery so that they remain cosmetically-appealing and barely noticeable. In our office, we use a protocol for scars that minimizes their activity in the 6-8 weeks after surgery. If you have late plastic surgery scars, you may also require laser and RF therapy to help reduce the longterm effects of the scarring. Keloids, hypertrophic scars, widened scars, red scars, and hyperpigmented scars all require scar modulation with topical creams followed by lasers and RF therapy. Topical skincare should be directed to a specific need, whether for pigmentation or hypertrophy and our office can guide you through the process to obtain the correct Plato’s Scar cream or Melarase cream for hypertrophy and discoloration. In terms of lasers, we would employ the vbeam laser for redness, Venus Viva RF, PRP microneedling, chemical peels, and Morpheus 8, fractional erbium, or fractional co2. All of these have their individual benefits. Most of all, we recommend you visit a solid plastic surgeon who understands surgical scar revision, laser therapy, and RF therapy for scars.

Best,
Dr. Karamanoukian
Realself100 Surgeon

There are multiple reasons why a an unfavorable scar may occur. One of the most common reasons is a person’s own predisposition to form a keloid or hypertrophic scar. If you have many other keloids on your body, from other scars or from getting your ears pierced, you will have a higher chance of forming another keloid. If you have many other scars all of which have healed well, then you will likely continue to scar well. Another reason of unfavorable scaring comes from tension at the incision site. If the incision is not closed properly there may be undue stress on the incision and may result in a widened raised scar. More serious complications with your surgical site such as an infection or necrosis will also negatively affect your final scar.In particular with many plastic surgery procedures the blood supply to the skin at the incision site could be compromised.  This can be due to tension at the wound, overly aggressive dissection or most importantly smoking.  Are you a smoker?It looks like you experienced delayed wound healing at the junction of your scars.  Early on this can be treated with anything from pressure massage, silicone sheeting, steroid injection, laser or an excision and closure.I would not recommend excising this scar for closure until at least 1 year after surgery.  At that time it would best be assessed by a board certified plastic surgeon to see if this would be possible.  The last thing that you would want is to undergo an excision and not have enough laxity for closure and be left with an open wound.I hope this helps

Every woman who has breast reduction surgery finds herself dealing with scar tissue after her wounds have healed. It appears from your pictures, you have very slow healing incisions.
 Scars are caused when the dermis, the layer of skin underneath the surface, is damaged. The body produces a fibrous tissue called collagen to close the wound and assist in healing. When collagen is left behind once the damage to the dermis has been repaired, a scar is the result. The extent of an individual’s surgical scars has much to do with genetics, age, the type of surgery. No two surgeries are identical and neither are the outcomes. Although most scars will fade and diminish over time, some can be difficult. Prevention is the key. However, if you have a history of scaring on others parts of your body, then this can be far more difficult. No one treatment for scars is best. I would suggest following up with the surgeon that performed your reduction surgery to discuss your options and any additional procedures.#plastic surgery #breast reduction #scars

The scars at this juncture unacceptable but are still obviously biologically active. This is part of the remodeling process and should be allowed to complete before considering a revision. Your plastic surgeon may have some strategies to deal with the scar going forward to maximize the final aesthetic appearance.

You may be developing a hypertrophic scar or keloid. See you plastic surgeon for advice. 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 is some general information on optimal scar management found in the below link. #breastreduction#breastreductionscar#scartreatment

I hope your surgeon will agree that your scars could be improved and will help guide you on this subject. I charge a small cosmetic fee for scar revisions and many times they can be done in the office under local anesthesia. In your case the procedure may need to be more involved. I do not use the T scar approach partly due to the common problems of bad scars. I have performed revisions of this type of breast reduction many times and can tell you that it is optimal only if you have some loose skin and after full healing (a year or longer) to regain as much good circulation as possible. Scars never heal well with poor blood supply or under skin stress. Ask your surgeon's office about good scar care, avoid gaining weight, and stop smoking if this is an issue while you wait for your tissues to recover more circulation. I wish you well and hope things heal nicely for you!

Dear misspositivity,The T junction area can be a tough area when it comes to healing. This area can be under quite a bit of tension and can even open soon after surgery, taking its own sweet time to heal. Once it does the scars can be very red and wide before they mature and fade.There are some things that your surgeon may want to do (or you to be doing) in the interim to improve the appearance of the scar in this area, especially if you are developing progressively firmer and larger thick areas,, but often we wait about a year and then decide if laser, scar revision, or nothing needs to be done.Sincerely,