Is It Normal to Have Scars This Bad 11 Months Post Op? Why Are my Nipples Flat Now? (photo)

Hi I had a breast lift and implants 11 months ago. The scars are so ugly and embarrassing. Will they ever get better with time, or is treatment the only answer? And how much better? I can't ever go brawless because around the areola's the scar is raised and show's through my shirt. Also I used to have nice protruding nipples before my surgery, and now they are flat. Which I hate. Will they begin to protrude again with time? Thanks you!!

Doctor Answers 11

Bad scars after mastopexy aug

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You have hypertrophic scars along the bottom and it sounds like you may also have them around the areolas. It doesn't look as bad in the vertical scar. This is the result of either your body's healing, or bad surgery. Do you have any other scars on your body? How did they heal? Regardless, at this point I think the best solution would be to have surgical scar revision (maybe not by the original surgeon), and plan on aggressively treating the scars post op with silicone gel sheeting or steroid tape. if it begins to recur in spite of this I would promptly start laser treatments. Do you have sensation in the nipples? If not, this might be why they are flat.

Scars after breast surgery.

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Yikes, those are wide and red scars.  They may fade and flatten with time but they will still be wide.  If you were my patient, I would likely do a scar revision and do everything possible to lessen the scarring.  I would use long lasting absorbable sutures in the deep dermis and make sure you tape your incisions for several months after surgery.  There would likely be less tension on your incisions compared to you initial surgery and there is a chance you would heal better. may just one of the unlucky ones that scars badly. 

Beware of steroid injections into these scars.  It could thin your tissue which could be a problem with your implants.

Best of luck!  Dr. Lisa Lynn Sowder

Hypertrophic Scarring

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Thank you for the question and pictures.

Based on your description and pictures  think you will benefit from scar revision surgery. Depending on your physical examination some improvement   in the nipples'   situation may also be achieved. The use of silicone sheeting and/or steroid injection may be helpful postoperatively.

I hope this helps.

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Breast lift and scars

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Your scars appear to be hypertrophic and spread.  Sometimes this happens with tension on closure during a breast augmentation and lift.  A scar revision may be helpful.

Undesirable scars following a breast lift

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Your scars are clearly wide, elevated and prominent - not what you want following a breast lift. The cause could be many including genetics, surgical technique and closure and wound tension. Lack of close follow-up and the usage of scar treatment such as topical silicone gel or sheeting could have exacerbated the problem.

At this point in time, you could benefit from a scar revision and close postoperative management of the scars such as with scar creams or silicone gel sheeting. You may even want to obtain a second opinion from a reputable board certified plastic surgeon. If there was a deficiency of the performance of the closure and postoperative care with your surgeon, it may not be in your best interest to repeat the same scenario (though I am not asserting that there was).

Is It Normal to Have Scars This Bad 11 Months Post Op?

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You have developed very bad hypertrophic scarring following your breast lift.  Unfortunately, it is not possible to predict who will heal with these abnormal, genetically-determined scars if they are in a part of the body where the patient does not have previous scars.  Some post-operative problems can lead to these (infection, a dehiscence or pulling apart of the incisions), but most cases are spontaneous and again are due to genetics.  The treatment would be by scar revision where the old scars are completely removed, but unfortunately there is a significant risk of recurrence.  Probably the most effective treatment to help prevent their return is a 3 day course of radiation treatment to the scars starting immediately on the day of surgery following scar excision and revision.  The main drawback with this is the significant expense of the radiation treatments, which can run into the thousands of dollars (and the possible but unlikely risks of radiation treatment need to be discussed with the radiation therapist). Short of that, scar revision, silicone gel sheeting for at least a few months, early injections with triamcinolone at the very earliest signs of recurrence are more common treatments, and oftentimes will help. If the closure at the time of scar excision (and shortening what appears to be some postoperative stretching of the lower pole of the breast) results in too tight a closure, going to a smaller implant might be needed, but an examination would help determine whether this may be necessary. Good luck with however you decide to proceed.

Breast augmentation together with breast lift

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You have a major problem. Without knowing the details it is impossible to know if that is just the way you healed, the way surgery was done or both. You will need surgery to fix this but just cutting out the scars will not help. The removal of additional tissues will just stretch the nipple areolar complexes even more and widen the breast fold scar more as well. You may have to go to smaller breast implants. You need to be very careful in choosing your surgeon for revision. If they promise you too much you will be better off going elsewhere.

I hope you realize that this format of posting questions and receiving answers lacks the face to face direct communication required for you to make an informed decision regarding your surgery.

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.


Aaron Stone, MD
Los Angeles Plastic Surgeon

Scars after breast lift

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This is 'the' question to ask yourself before completing a breast lift. A mastopexy always will leave a scar and it just will not work out for some. The droop or ptosis can be easier to live with. Breast lift is a great procedure if well designed and performed, and if well understood, and the less scar the better. Your scar might do better with a revision.

Best of luck,

When to consider revision for scars

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The pctures show what are known as hypertrophic scars, which could be either from the way you heal, skin flaps too tight, or some other event during the early healing phase. Scars generally fade, flatten, and soften for up to a year, but when they are widened like yours they would probably benefit from a revision surgery. Since you are almost a year out, it is an appropriate time to consider it. if it starts to recur then laser treatments or injections could help but would not be ideal treatments at this stage.

Hypertrophic breast scarring

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My question is whether you returned to your plastic surgeon for followup.  Scar hypertrophy can be controlled by use of silicone sheeting and/or kenalog injections.  You haven't mentiond either.  At this point, you would need to undergo a scar revision with regular followup treatment afterwards.   The need for followup and participation in the post-operative process by the patient cannot be underestimated in terms of the surgical outcome.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.