Why are my breast augmentation incision scars so visible & thick? (Photo)

Plastic surgery scars require attention after surgery so that they remain cosmetically-appealing and barely noticeable. In our office, we use a protocol for scars that minimizes their activity in the 6-8 weeks after surgery. If you have late plastic surgery scars, you may also require laser and RF therapy to help reduce the longterm effects of the scarring. Keloids, hypertrophic scars, widened scars, red scars, and hyperpigmented scars all require scar modulation with topical creams followed by lasers and RF therapy. Topical skincare should be directed to a specific need, whether for pigmentation or hypertrophy and our office can guide you through the process to obtain the correct Plato’s Scar cream or Melarase cream for hypertrophy and discoloration. In terms of lasers, we would employ the vbeam laser for redness, Venus Viva RF, PRP microneedling, chemical peels, and Morpheus 8, fractional erbium, or fractional co2. All of these have their individual benefits. Most of all, we recommend you visit a solid plastic surgeon who understands surgical scar revision, laser therapy, and RF therapy for scars.

Best,
Dr. Karamanoukian
Realself100 Surgeon

As all of us are different, our bodies' responses can also be different; so, there is not one and the same healing for all the people.In accordance with this, while the vast majority of people have scars, which settle down to unnoticeable marks, there is some people, whose scars remain troublesome and noticeable. These are the most common scar problems seen in plastic surgery: hypertrophic scars, keloid scars, pigmented scars, lumpy scars, stretched scars, tight scars (scar contracture), persistent redness, indented scars and scars that have caused an abnormality of contour of the surrounding skin.Unfortunately, it looks like you have hypertrophic scars, which is requiring multiple treatments.Try these tips:Silicone gel sheets. These combine the effect of providing gentle pressure along with the effects of the silicone itself. Steroid Injections. Keloid or hypertrophic scars often respond to micro-injections of steroid (triamcinolone) directly into the scar. Laser treatment. Is good for two reasons: one is redusing redness, the second is resurfaceing the irregular scars.Massage. Some types of scars are associated with persistent and troublesome swelling. Surgical treatment of scars. Can reduce the visibility of the scars. If other treatments do not work you can consider it also. I hope this will help..

Thank you for your question. Breast incisions can be managed using a multimodal approach:1) Scar massage - starting as soon as the surgical dressings come off and the incisions are sealed2) Silicone sheets or scar gels for about six months to year3) Embrace - a tension reducing dressing for the first 2 months4) Fractionated lasers to help blend the scar into the background - done as a series, starting about 4 weeks after surgery and repeated every four weeks for six months.5) Sunscreen to prevent the scars from darkeningThe main role for silicone sheets is to keep the incisions hydrated during the remodelling phase of the scar maturation. This allows the underlying cells to work in a more optimized fashion. The brand is less important but compliance usually follows ease of use. Silicone usually has less skin irritation concerns with use compared to adhesives. They can also be re-used. At this point, you can try the fractionated lasers, or consider a scar revision and then a multi-modal approach to the healing process.

Hello! Thank you for the question!  The typical incision used for breast augmentation are: inframammary (in the fold beneath your breast), periareolar (at the border of the areola), axillary (within the armpit crease), and TUBA (through the umbilicus). Incision placement will do a lot with your preference, surgeon comfort level with that approach, and the type of implant - silicone implants will be difficult to place within certain access incisions. Breast augmentation scars are well concealed and are very discrete. They should not be visible within clothing, and likely hidden without clothing. If your concern is the visibility without garments, you should consider remote access incisions such as in the armpit. However, these other incisions heal very well on the breast and often times inconspicuous.  It is common for scars to fully mature for up to a year. In the meantime, there are a few things that may help to ameliorate your incision/scar. The most proven (as well as cheapest) modality is simple scar massage. Applying pressure and massaging the well-healed scar has been shown to improve the appearance as it breaks up the scar tissue, hopefully producing the finest scar as possible. Other things that have been shown to add some benefit, albeit controversial, are silicone sheets, hydration, and topical steroids. In addition, avoidance of direct sunlight to the incision will significantly help the appearance as they tend to discolor with UV light during the healing process.  At 12 months postop now, other things that you may consider are intralesional steroid injections, laser, or just surgical revision of the scar itself.Consult with a plastic surgeon your goals, concerns, and expectations. Certainly incisions should be considered, but should not limit your overall result by hindering visualization and access to your surgeon, and what produces the best results in his/her hands.Hope that this helps! Best wishes!

Thank you for your pictures.  Your scars are wide and have increased pigmentation.  There length seems a bit excessive also.  This could be due to poor technique and/or excessive tension on the incisions.  Surgical removal of the scar can improve this but this lengthens the final incision as well.Earl Stephenson, Jr, MD,DDS, FACS

The scars continue to improve for two years, so they may get better. However, having said that, at this point I would consider revision. Excise the scars under local anesthesia, and re-close in the office. Keep out of the sun and tanning beds for a minimum of 6 months.Greg Sexton, M.D.Columbia, S.C.

Yes your incisions still very "red" but maybe hydroquinone cream to area and possible derma rollers to help lighten the area.. 

Some people heal differently than others, and some take longer to resolve. If the redness bothers you, sometimes laser can help. If the scar is too wide, a scar revision may help now that the tissues are all stretched from the implants. Hard to say what would be best for you without ane xam.

If you have the only visible, thick scarring among the people who you know who had the same surgeon, then you healed differently, because your genes are different. One year is not that long. They might fade as time passes. Wait a year. Use over the counter scar treatments. Going bigger is not the answer.