What can I do about these hideous weird shaped nipple scars? (Photos)

Scars widen because of several factors. In this case, the likely cause is tension on the incisions as the sutures dissolve. Kenalog doesn't help because the scars are not thick/elevated. Microdermabrasion and steroid tape don't work for the same reason. And you cannot change your ethnicity or skin type. Fortunately, this type of scar tension is well avoided with the use of the gortex permanent suture. In our hand, It does not increase scarring (like mastopexies). It decreases the width of the areolas, and doesn't cause hypopigmentation in pigmented skin. 

Hello XiaoyuX:   It appears as though you had a circumareolar or "donut" mastopexy.  Enlarging areolar diameter is a common outcome of this type of breast lift procedure unless a permanent suture is placed all the way about the areolar incision to prevent tension on the breast lift from stretching the areolae.  The good news is that more than likely your look can be significantly improved by placing the permanent suture around the areolae.  Personally I use a Gortex suture but there are other options available.  Return to discuss this with your surgeon.  If you don't like what s/he has to say, seek another opinion or two.Best of luck to you!G. Robert Meger MD

 I agree that revision could be done in your particular case using Gore-Tex and I think your outcome would be better. This can be done in the office under local anesthetic with no need to return to the operating room. I think it’s worth trying!

It is likely that the size and edges of your nipples can be improved.  However very small nipples may not be achievable without considerable scarring.  

Hello,You will not get what you want from a simple revision of the circumareolar lift; it will return to its current appearance. You will need a conversion to a formal breast lift. Please discuss with your surgeon and/or get a second opinion from an ABPS certified/ASAPS member surgeon. Best of luck!

Dear XiaoyuX,For scars, I close all of my incisions in 5 layers and do not use absorbable sutures because they cause inflammation and worse scarring. I tape all of my incisions in the office visits once a week for six weeks after surgery to improve the appearance. After taping, I start my patients on a scar gel therapy for 3 months that they have to put on their incisions twice daily.You should discuss your concerns with your plastic surgeon as different surgeons have different approaches in scar management.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

are very challenging to 'fix' and even with permanent sutures... if they pull through your tissue as often they do, the scar will start stretching out again.  You have to decide how much effort, costs, and emotion you want to put into trying to make this better as things can always be tried.  But if you can focus on how much better (even with the scars) you look post-op in your clothing, you may want to consider doing nothing and living life.  Anyone who is lucky enough to see your scars should be supportive and loving... and if not, they do not belong in your life.

Thanks for the question and photos. It appears you had a periareolar (donut) lift, which is notorious for the risk of spreading of the areola and/or scar when significant lifting is attempted. I now reserve the perilift for lifts of 1-2 cm max, and prefer the vertical (lollipop) approach for most patients. Conversion to a vertical technique can often help correct the areolar and scar spread that has occurred from the periareolar surgery, as the tension gets redistributed in a way where there is less pull around the circle. Go on some consultations with board-certified plastic surgeons with expertise in revision breast surgery.

Hi and thanks for your question.  It sounds like you were doing everything right.  One of the biggest risks of an augmentation mastopexy (or lift with an implant) is scar widening over time.  This is because you are putting tension on the scars are they are healing.  I would suggest attempting a scar revision and potentially reduce the size of your areola at the same time.  It sounds as if you are already an expert in postoperative scar care :)  Hope this helps!

From your photos, you are an excellent candidate to revise the scars with a more permanent deeper suture to prevent the tension and subsequent widening. This will also help to reduce the width of the areola as well. You should see a board-certified plastic surgeon in your area to get a formal opinion through an in-person consultation.
Best of luck!