Painful Scars After Breast Lift

If you are experiencing new symptoms such as bruising and pain that you did not have a few weeks ago, I recommend seeing a plastic surgeon immediately.  Even though your surgeon is out of town, you must see someone to determine that you are not having a hematoma or infection.  The scars will naturally be red at this point but the pain and bruising do not sound normal for this time frame. Based on your photos, it appears to be healing fairly well, but this is difficult to say without examining you.

You can even be seen in an emergency room if need be.

Best wishes,

Dr.Bruno

Hard to tell as you are still early in the recovery period and mild itching is common. However, Best Scar Management is important to minimize or completely hide from view, the telltale signs of your surgery—namely, scars. Both you and your surgeon want you to have the most minimal scarring possible. There are many possible causes for scars that are enlarged or not healing well. Unsightly scars are most commonly due to genetics, underlying medical conditions, or improper scar/wound care. The last part is very important and patients can make a noticeable difference in their scars’ appearance by following best scar management practices. Here are some simple tips in the link below:

It’s important to realize
that scarring is inevitable after any surgical procedure.When breast lift is performed, every effort
is made to hide the scars where they won’t be noticeable.Incisions are typically hidden in the fold of
the breast and at the junction between the areola and surrounding skin.Unfortunately, in rare cases, adverse scarring can
occasionally occur.This is usually due
to wound healing biology and it’s frequently seen in patients with darker
pigmentation.In some cases,
hypertrophic scarring can occur.This
scarring is characterized by raised, red, painful, itchy scars.It’s important to remember that wound healing continues
for over a year after surgical procedures.During the initial phases of wound healing there are several maneuvers
that can be performed to minimize scarring.These include mechanical massage, the use of silastic sheeting, and
topical agents such as Mederma.Even
when these methods are used, scarring may still be a problem.If scars have failed to improve after they have reached
maturity, scar revision may be an option.If you’re concerned about hypertrophic scarring, you should consult your
plastic surgeon.Your surgeon should be
able to recommend an appropriate course of action.

Thank you for the question. Immediately after surgery, it is
normal to experience temporary soreness, tightness, swelling, bruising and sharp
stabbing pain around the breasts and incisions for several months.
Swelling will reduce and breasts will usually settle around three months.
Contact your physician immediately if you have severe or increased pain
not relieved by medication, increased redness along the incisions and greenish
drainage from the incisions. I hope this has helped.

Based on your photos it appears that you have hypertrophic scars (not keloid scars) evolving.  Although they are not dangerous per se they are more itchy and unsightly compared to typical scars.  Also it's important to note that hypertrophic scars are typically more a result of patient's genetics as opposed to surgical error.  The "bruising" you see this delayed after surgery may be post-inflammatory hyperpigmentation - hyperpigmentation that follows bruising but typically regresses over a year or two.  Nonetheless, I encourage you to see a local plastic surgeon for a live exam to confirm all this.  Best of luck... 

Thank you for the photos. What I see in your photos are mildly hypertrophic scars around the nipples and normal vertical scars. As scars heal, they often become quite itchy. Massage and lotion can help significantly with the symptoms as well as hasten the fading of the scars and to flatten them as well. Silicone sheeting can help nicely with this as well. As far as pain, some patients will experience a "pulling" type pain as the scars inside the breast contract. This is normal and generally resolves over a few weeks. If the pain is significantly out of proportion, then I recommend following up with your plastic surgeon or the surgeon covering his practice while he is out of town.

I would not characterize the small red dots in the left breast photo as bruising. This looks like simply ruptured capillaries. This should fade in a matter of weeks. From your photos, I would say the likelihood of keloids or an allergic reaction are quite low.

It is unusual to have bruising and then pain at this point after surgery. Even if your doctor is out of town, I am sure he has coverage in case of an emergency.

Your photos indicate that the scars around your areolae are becoming hypertrophic.  Hypertrophic scars, which are genetically determined,  are red, raised, rope-like, and often are itching and hypersensitive. You should contact your surgeon to see what treatment they would recommend.  I have my patients wear silicone gel tape for 4-5 months after a lift to try to improve the scarring and lower the risk of hypertrophic scarring.  If someone still is tending towards this type of scarring despite the gel taping, I consider some judicious and conservative injections of triamcinolone (Kenalog).