Can theses 5 year old breast augmentation armpit scars be removed with scar removal surgery? (Photos)

Question

I got breast augmentation 5 years ago through incisions made in the armpit. The scars eventually widened and are quite pigmented. I did no after care for these immediately after the surgery, and have only recently begun doing Fraxel laser treatments and Excel V treatments for them (6 Fraxel and 2 Excel V). The color and texture have admittedly improved, but progress is slow and they are noticeable when my arms are not raised. I am wondering if these scars are good candidates for scar removal surgery considering they are older scars, or if there are additional/alternatice treatments I could do to have them fade almost completely. I asked my original surgeon and she said she could not guarantee the scar wouldn’t widen again, but I also never followed proper wound care so just wanted to get some second opinions. Thanks!

Anna Chacon, MD, FAAD · Answer

Thank you for your detailed question. Scars from transaxillary (armpit) breast augmentation can sometimes be more challenging due to constant motion, sweat, and tension in that area. Given that your scars are 5 years old, widened, and pigmented, it's understandable to seek better outcomes after limited early care.

Can Scar Removal Surgery Help?
Yes, surgical scar revision can be a helpful option, even for older scars—especially if:

The scar is wide or raised.

It is cosmetically bothersome and hasn’t responded well enough to non-surgical methods.

You are now able to commit to proper post-op care, which is essential to prevent recurrence.

However, your previous surgeon was correct in saying that recurrence is possible, especially in high-movement areas like the axilla. That said, many patients who adhere to a strict post-surgical care routine (e.g., silicone taping, compression, avoiding tension/stretching) see excellent improvements.

Additional or Alternative Non-Surgical Options
Since you've already had 6 Fraxel and 2 Excel V treatments with some improvement, you’ve done a solid foundation of care. You can consider the following next steps:

1. Microneedling with PRP or Radiofrequency (RF Microneedling)
Stimulates collagen remodeling and improves scar texture and pigmentation.

Especially useful if scars are indented or have irregular borders.

2. CO₂ or Er:YAG Laser Resurfacing
More aggressive than Fraxel and may yield better results for thicker, textured scars.

Multiple sessions are often needed.

3. Steroid Injections (if hypertrophic or keloidal)
Helps flatten raised scars and reduce redness or discomfort.

4. Silicone Sheeting or Gel
Still effective even for older scars—used daily for 2–3 months to help flatten and fade scars further.

5. Topical Agents
Products with tretinoin, hydroquinone (for pigment), vitamin C, and peptides may continue to support improvement.

Summary:
Yes, surgical scar revision is an option and often successful with proper post-op care.

Non-surgical methods like RF microneedling, CO₂ laser, or ongoing topical therapy may still offer meaningful progress.

Prevention of recurrence post-revision is key: strict wound care, minimal tension, and possibly laser or silicone therapy afterward.

You've already made significant progress—what’s most important now is personalizing the next steps based on the scar’s characteristics and your tolerance for downtime.

Raffy Karamanoukian, MD, FACS · Answer

Fractional laser is an amazing and highly effective treatment in our office. We use the laser treatment to help with acne scars, large pores, fine wrinkles, tissue collagen loss, scars, sebaceous hyperplasia, active acne, and for brightening dark pigmentation. Although there are very strong fractional lasers such as CO2 laser, we use lighter treatments for corrective skincare and maintenance of results. Our Thulium fractional laser, clear and brilliant laser, and Ultra Thulium laser are excellent options in our clinic. We also perform CO2 fractional and erbium depending on skin tone and tolerance for downtime. Patients do have to use a Melarase cream before and after treatment to help further reduce pigmentation after laser.  Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. Dark spots can improve with these treatments. I recommend fractional laser for incisional scars as well, especially after plastic surgery.  
Best,
Dr. Karamanoukian 
Realself100 Surgeon

Can theses 5 year old breast augmentation armpit scars be removed with scar removal surgery? (Photos)

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Everything you need to know about Scar Removal

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Can theses 5 year old breast augmentation armpit scars be removed with scar removal surgery? (Photos)

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Everything you need to know about Scar Removal

Our mission is to create a world where every investment in modern beauty is Worth It.