I developed a keloid from a skin cancer biopsy on my upper chest and am fearful that a keloid could develop from BA incisions.

The upper breast area is much more prone to keloids and a scar placed in the crease under the breast would have much less of a chance of keloid formation. Having said that if you have had a true keloid then you may be at higher risk and it will be important to minimise scar length - the use of a Keller Funnel sleeve can help reduce the incision length to as short as 1.5 to 2.5 cm 

All surgery carries some level of risk, including breast augmentation. #Hypertrophic or #keloid scars can be a problem.  The worst are usually under the breast with an #AnchorLift or inverted “T”.  These can be treated like all thickened scars with re-excision, laser, kenalog/5-FU injections, creams, silicone strips and other methods to reduce and improve healing. The best thing to do is to ask your surgeon about this issue directly during pre-op consultation to check on the specific scars an incisions you already have in relation to the type of procedure that is best for the results you desire.

Thank you for your question.  

Unfortunately, the area where you had a biopsy is very common to develop scar thickening called hypertrophic scarring.  This is similar to keloid formation, except keloids act as a benign tumors that continue to grow outside the original surgical site.  Many physicians use the terms interchangeably, but they have distinctly different underlying pathophysiology.  

That having been said, hypertrophic scarring is relatively uncommon (but possible) with breast augmentation.  There are a variety of techniques to avoid such problems; avoidance of sutures in the skin, multiple layered closure of the incisions, placement of the incision away from friction or pulling, early institution of topical anti-scarring products, use of silicone gel sheeting, non-invasive laser treatments, to name a few.

Be sure to discuss these concerns with your board certified Plastic Surgeon.  Good luck with your planned surgery!

It is possible that you may develop a keloid or undesirable scar from a breast augmentation and you would have to decide what risks you are willing to take if you really want it done. I have had multiple patients that have thick or keloid scars in other areas who healed well from breast augmentation without keloids. You could do take calculated risks such as: have the scar in the inframammary fold so that it is well hidden below the breast, use silicone sheeting and have steroid injections at the first sign of the scar getting thick. Best wishes!

Thank you for your question.

Unfortunately, if you already had a keloid scar, then you are at increased risk of developing another unless the keloid appeared on the earlobe, which is not the case in this scenario.

It is recommended that unless important, all non-essential surgery should be avoided when there is high risk of keloid formation.

Here is some information that would help you decide whether to go ahead with breast augmentation surgery and take the risk or not.

• Keloid occurrence is 15 times higher in persons with dark and highly pigmented skin.
• Keloid are also more common in persons between the age of 10-30 years.
• There may be a genetic link, and so if you have an extensive family history of keloid occurrence and recurrence, then you have to consider this.
• Interestingly, higher rates of keloid are also seen in patients with type A blood group.
• In individuals at risk of keloid recurrence, the sternal skin (where you have it currently), shoulders, upper arms, earlobes, and cheeks are most susceptible.
• Excessive trauma as caused by burns, ear piercing, biopsy procedures, and lacerations are more likely to result in keloids, especially when there is an infection.
• Finally, if there is high risk of keloid formation, surgeons can take precautionary measures to prevent with immediate silicone elastomer sheeting, taping to reduce skin tension, or corticosteroid injections.

So having this information, consult with a board-certified plastic surgeon and hopefully something can be done.

Best of luck!

The area of the chest where you got the bad scar is one of the most common areas for bad scarring. It usually does not happen on the breast.I would recommend an inframamary or axillary approach to hide scarring.

Some areas are more likely to develop poor scar than others.  Above your nipples, deltoid areas, and midline torso areas are more likely to form widened scars.

Breast augmentation with fold incisions rarely produce bad scars even on patients who have poor scars in other areas.

Best Wishes,

Nana Mizuguchi, MD