What is this dark mark on my incision scar? (photo)

Question

I had a breast aug 9 months ago, and in the early weeks following the op one of my scars showed signs of a little bleeding where it hadn't healed as well as the rest of the incision. I treated this with iodine and kept it covered as recommended by my surgery. It cleared up over time as normal. However, this little brown mark has never gone. It's smooth to touch (I massage the scars with oil twice a day) but up close it does look like a little scab or blood blister. Should I seek advice from a GP?

Raffy Karamanoukian, MD, FACS · Answer

Our treatments use combination therapy to improve the epidermis and dermis for most deep scars. The options available for acne scars depend on the character of your scars, in terms of topography and contour. We see atrophic and hypertrophic acne scars, as well as scars that have hypo and hyperpigmentation. We begin each scar evaluation with an assessment of scar quality and subtype. Our main concern is rebuilding collagen and that is why we use a HIDEF protocol that includes combination therapy. Morpheus 8, scar subcision, fibrous release, fractional laser, CO2 laser, Thulium laser, PDL Vbeam laser, and fractional resurfacing can be used in addition to TCA Cross and chemical peels to further improve skin. Patients should start Melarase AM and Melarase PM for active hyperpigmentation. Always begin with a consultation to decide whether early subcision should be started.

Best,

Best,

Manish H. Shah, MD, FACS · Answer

Hello BaliBuddah,Thanks for your question.While this might be prolonged iodine staining of the tissues, it makes sense to check with your GP to make sure it isn't something worse.  It may benefit from a trial of a skin bleaching cream or IPL to break up pigment.Good luck,Dr. Shah

Robert P. Schmid, MD · Answer

This dark spot may b one of several things. It is hard to say from the photograph. I would def c ur plastic surgeon to let them evaluate it. U may need either topical lightening cream, laser treatments, or just excising it. Hope that everything turns out ok!

Bradley A. Hubbard, MD · Answer

I think you have stumped all of us so far! It is quite difficult to give a diagnosis from the picture alone. Sorry! Best to follow-up with your PS.

Sheila S. Nazarian, MD · Answer

Honestly, it is impossible to say from a photo. Schedule an appointment with your surgeon so that he or she can assess the situation in person. Best, Dr. Nazarian

Ravi Somayazula, DO · Answer

Not exactly sure what this spot is. Although highly unlikely at this point it could represent a spitting suture, but at 9 months all your sutures should be dissolved....hmmmm a tough one. You should see either your GP or PS. It may need to be biopsied , and excised and closed. IPL or bleaching may be effective as well, but a biopsy will allow for a diagnosis. Either way you should be seen in person and examined. Good luck and congratulations!regards,Dr. Ravi Somayazula

Kailash Narasimhan, MD · Answer

Hello and thank you for the question; certainly have your plastic surgeon evaluate but if it is a scab it might slough off.  Occasionally along the edges of the incision the skin can superficially slough.  Good luck!

Jeanette Padgett, MD, FACS · Answer

Looking at your photo, it is difficult to tell what the dark mark is.  I would suggest that you return to your plastic surgeon for an examination.  Best wishes.

Bryan Correa, MD · Answer

It is difficult to tell based on the submitted photo - I would show it to your surgeon so an exam be performed. Good luck!

Robert N. Young, MD, FACS (retired) · Answer

Since it's been 9 months since your surgery, it is a bit unusual. You mentioned the use of iodine, and while it may be staining, it would be a good idea to return to your PS or your primary physician and have it examined. Unfortunately there isn't enough detail in the photo to tell what it may be, as it looks almost like a large freckle or mole.