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

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