10 months post op - should I consider a breast implant revision along with scar revision? (photos_

Our office has many different treatments for scars depending on the depth of atrophy or hypertrophy. Scars require a combination approach using our HI DEF protocol which uses a combination of lasers, topical scar modulation, and RF treatments to pixelate scars, improve contour, reduce hyperpigmentation, and improve the visibility of the scars so that they are no longer visible in ambient light. Everyone has a unique pattern of scarring and we employ our HIDEF technique to improve texture, color, contour, and topography. We often use a combination of treatments that begin with a careful examination to examine the micro texturing of the acne scars. Atrophic scars and indented scars can benefit from injectable fillers such as Radiesse, Sculptra, and Restylane with or without subcision to remove tethered scars and atrophic depression. Hyper-redness in scars can be improved with V beam laser, Excel V, BBL, IPL, and Venus RF to improve the redness and reduce the visibility of deep scars. Fractional Thulium laser and clear & brilliant can also reduce the inflammation and redness of the scar when combined with topical therapy. Fractional lasers such as Fraxel, erbium, and CO2 laser can be combined with radio frequency and also fractional RF to improve textual issues and microtopography. Subcision and TCA cross are also used for deep ice pick scars and narrow valley scars in order to improve the micro texture. Above all, our combination approach with our clinical nurses and board-certified plastic surgeons can improve the quality of your skin by using at home Melarase creams combined with PRP treatments in our office to improve your skin quality and tone. I recommend getting a formal evaluation with an experienced team of experts in order to reduce your scarring.

Finally, hyperpigmentation of scars can be improved with at-home Melarase AM, Melarase PM, and Melapads to help reduce active PIH and melanin deposition.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Dear mm34555,
breast revision surgery is the most difficult plastic surgery procedure performed. Botched breast surgery alters normal tissue planes and laxity, the ability of breasts to heal properly, and leaves scar tissue that dramatically affects the level of difficulty of the corrective surgery.Many patients come in to correct poor outcomes from their initial surgeries. The most common problems are due to implant malposition, bottoming out of the implant, poor scarring, and incorrect implant size.While the type of revision required will depend on the result of the previous surgery and the desired result of the patient, some revisions involve extensive pocket repair that may or may not need specialized external bras.If you are considering breast surgery revision, you should speak with a board certified plastic surgeon and have yourself properly assessed. Only after a thorough examination you will get more information and recommendations. Also, you have to make sure that your surgeon understands your breast augmentation goals.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

It does appear one breast is lower than the other. You can consider a revision to correct that when you have your scar revision performed. You do not need to consider different implants unless you are unhappy with the volume currently.

The inferior pocket of your lower breast could be tightened when the scar revision is being done. Please discuss this with your surgeon.

The first question, someone should ask when contemplating a scar revision. Is will the scar heal differently the second time around?
Unless you can answer that question you shouldn’t have a scar revision, and instead consider managing the scar until it becomes mature, which is usually 18 months from surgery.
Breast asymmetry is very normal and women’s breast never look the same. The question you should be asking yourself is not if the breast look the same, but if the implant is placed correctly on each breast.
Raising the implant on one side can be done using internal sutures or internal sutures with supporting mesh or cadaveric dermis, such as Alloderm.
I suggest you discuss your concerns with your provider well in advance having surgery.Hypertrophic scars can be challenging, and there are a few things that can be done to minimize the access for Mation of scar tissue. Silicone sheeting may be a good option if you have not done so already.
A scar revision and implant revision may be reasonable if it’s well, I thought through.
Consider, having proper second opinion, consultations with other providers if you have concerns about the carrier receiving from your provider.
Best,
Mats Hagstrom, MD