Can I have a second reduction and if so will MD automatically do treatment to prevent keloid scars? (photos)

The technique I recommend is The Bellesoma Method. This will reduce and reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained, if not injured during your previous surgery.

Best Wishes,

Gary Horndeski, M.D.

Keloid scars are characterized by their growth potential and increased degree of inflammation within the skin. Unlike non-inflamed scars, keloids have the potential for growth beyond the original footprint of injury. Our office specializes in the management of keloids, whether single or multiple, using a combination platform that includes lasers, RF, scar modulation, Parke-Davis Scar Protocols, and injection therapy. Some keloids will require surgical intervention as an initial step for treatment.
Best,
Dr. Raffy Karamanoukian
Realself 100 Surgeon

You can have a second reduction - though the complication rate may be higher. At my office, if someone is very prone to keloids, I will plan before surgery that you will get some injections after surgery to reduce the risk.

Thank you for your question those beautiful photos! It is possible to have a second breast reduction, however the technique used during this second breast reduction is very important. With any breast procedure, but especially breast reduction, many tiny vessels and nerves are disrupted, and with this comes the risk of losing sensation or losing blood flow to the nipple, causing nipple necrosis or nipple death. With each subsequent breast reduction, the risk goes up slightly. I recommend returning to your original surgeon who performed your first breast reduction because he knows the technique and pedicle type he used and can more easily navigate your breasts to properly plan a safe procedure. As for keloid prevention, some centers may provide some complimentary treatments such as Kenalog injections or excisions, however this is on a center-by-center basis.

Hi,
Thank you for the question.
Based on your photos, you appear to be a good candidate for a second breast reductions surgery. During breast reduction surgery, excess breast tissue is removed, the breast is lifted and nipple/areola is typically made smaller. It is easiest to think of breast reduction as including the breast lift.
Regarding preventative treatment for keloids, one way to address it is to inject Steroid medication called Kenalog at the time of surgery and then afterwards in the postoperative period. While this significantly decreases the risk of keloid recurrence, unfortunately it's no 100% guaranteed. I also recommend special scar treatment regimen after the surgery to help minimize keloid recurrence.
I suggest that you seek an in person consultation with a Board-Certified Plastic Surgeon specializing in Breast Reduction surgeries to further discuss your options, specific techniques, concerns and expectations. Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and evaluate their results.
I hope this helps.Best regards, Dr. Karanetz
Dr. Irena KaranetzBreast Fellowship-TrainedBoard Certified Plastic Surgeon

Dear Imaginative2118,
breast reduction is best suited for women who wish to decrease the size of their breasts. While there are different techniques used to perform this surgery, I prefer the vertical incision (lollipop pattern) breast reduction technique instead of the anchor scar pattern, which reduces more noticeable scarring than usual. I also use a SAFE liposuction technique to reduce additional fat around the stubborn axilla area and bra line. This way, my patients are achieving beautiful results with minimal incisions which reduces downtime and delivers an overall better breast shape long term.If you are considering breast reduction surgery, you should consult with a board certified plastic surgeon to discuss your options and make sure your surgeon understands your goals. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

For keloid formers, there is not a way to prevent keloids. In general, the longer the scar or the greater the number of scars, the greater the chance for keloids. The keloids may require multiple modalities to achieve the best results. Because having the keloid scars removed and then receiving radiation treatment worked for you after your first BR, you will likely follow the same protocols.

Yes it is possible to have a second breast reduction. Discuss your history of keloid formation with your surgeon. She/He will work with you to help promote favorable scars and can watch for early signs of keloids. I've included a video I hope you find helpful.