What are my best options for improving mastopexy scar texture? (Photo)

Question

I got a breast lift + augmentation in March 2021, and this is how I've healed so far. My scars are textured/raised/indented/wrinkled/thin in some areas and I want to know what are my best options for improving texture and making the skin more smooth and even. I've read that micro needling could be effective in improving skin quality and texture. Micro needling, filler, or fat transfer to fill in thin skin? Or perhaps something else I did not mention? What are my best options? Thank you

Raffy Karamanoukian, MD, FACS · Answer

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

Jamé Heskett, MD · Answer

Hi, the best approach to this scar is to use carboxy therapy. Carboxy therapy is the injection of medical grade CO2. The CO2 restarts the healing process that has stopped and left you with a scar. The scar is injected weekly for 4 weeks and then twice a month until the improvement reaches a plateau. The result will be a shrinking or narrowing of the scar, a filling in of the scar if there is a defect and repigmentation or lightening of hyperpigmentation.  You can expect at least 50% improvement in the scar and I would expect to do 10-15 sessions.

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