Will my Breast Augmentation Scars Fade? (photo)

Question

So i am shy of four days of 2 month post op. my scars are a bit raised and red i was wondering if these look normal? i emailed my PS and the secretary told me that they look normal and that the body initally does this and will eventually flatten out?... in may i am going from 475ccs pro plus to most likely 700ccs HP ... will my PS recut the same incision? if so can he fix this at the time of me second operation if it still looks raised in the next two months?

Brian K. Reedy, MD · Answer

Your scarring is a little hypertrophic at 2 months post-op. I would consider some steroid injection, scar cream and silicone gel sheeting. Scars will improve and mature for a year or more. In some patients we will also use the Pulse Dye Laser. However, with additional surgery coming up in May, your PS will use the same incision. He can excise that scar and possibly you and he can be more proactive this time around. Good Luck!

Ercan Karacaoglu, MD, FEBOPRAS · Answer

I would recommend you to wait until your next surgery. The same incisions can be used, and your scars excised. You are likely to have the same problems with healing, and I will kindly advise you to discuss this issue with your surgeon. There are interventions, which he can be done to help you with your healing next time: correction with laser, Intense pulsed light, chemical peels,  steroid  injections, and silicone occlusion.

Young R. Cho, MD, PhD · Answer

Thank you for your question.  Breast incisions can be managed using a multimodal approach:1)  Scar massage - starting as soon as the surgical dressings come off and the incisions are sealed2)  Silicone sheets or scar gels for about six months to year3)  Embrace - a tension reducing dressing for the first 2 months4)  Fractionated lasers to help blend the scar into the background - done as a series, starting about 4 weeks after surgery and repeated every four weeks for six months.5)  Sunscreen to prevent the scars from darkeningThe main role for silicone sheets is to keep the incisions hydrated during the remodelling phase of the scar maturation.  This allows the underlying cells to work in a more optimized fashion.  The brand is less important but compliance usually follows ease of use.  Silicone usually has less skin irritation concerns with use compared to adhesives.  They can also be re-used.

Jerome Edelstein, MD · Answer

Scars that are red and raised mean that they're new, and this is normal during the three to six months after your surgery. This will eventually. You should protect your incision from direct sunlight to prevent permanently darkening the scar. If it is dry, you should apply a non-irritating moisturizer to it. With proper care, your scar will eventually become thin and silvery. This can take a year. Silicone gels and strips have also been found to help scars mature properly. Your surgeon may use the same incision placement, however please ask to make sure.

Lewis Albert Andres, MD · Answer

Hello! Thank you for the question!  The typical incision used for breast augmentation are: inframammary (in the fold beneath your breast), periareolar (at the border of the areola), axillary (within the armpit crease), and TUBA (through the umbilicus). Incision placement will do a lot with your preference, surgeon comfort level with that approach, and the type of implant - silicone implants will be difficult to place within certain access incisions. Breast augmentation scars are well concealed and are very discrete. They should not be visible within clothing, and likely hidden without clothing. If your concern is the visibility without garments, you should consider remote access incisions such as in the armpit. However, these other incisions heal very well on the breast and often times inconspicuous. It is common for scars to fully mature for up to a year. In the meantime, there are a few things that may help to ameliorate your incision/scar. The most proven (as well as cheapest) modality is simple scar massage. Applying pressure and massaging the well-healed scar has been shown to improve the appearance as it breaks up the scar tissue, hopefully producing the finest scar as possible. Other things that have been shown to add some benefit, albeit controversial, are silicone sheets, hydration, and topical steroids. In addition, avoidance of direct sunlight to the incision will significantly help the appearance as they tend to discolor with UV light during the healing process. If unsightly scars are still present after approximately a year's time, other things that your surgeon may consider are intralesional steroid injections, laser, or just surgical revision of the scar itself.Consult with a plastic surgeon your goals, concerns, and expectations. Certainly incisions should be considered, but should not limit your overall result by hindering visualization and access to your surgeon, and what produces the best results in his/her hands.Hope that this helps! Best wishes!

Gregory Turowski, MD, PhD, FACS · Answer

Scar formation is the end result of healing process. Scar will mature within some time. It can take up to one year to see significant difference in the scar appearance. It is recommended to start scar treatment as soon as the surgical incisions are completely healed. There are many products that can be used to reduce the appearance of the scar. There are special creams, silicone gels and silicone strips that help to soften, smooth the scar, and improve its color and texture. It is important to use the products under the physician’s supervision. Avoid exposing the scar to the sun for at least 6 months. Unfortunately under the breast(inframmary ) scars are the worst choice they are very unpredictable in appearance and frequently are very conspicuous I prefer armpit or periareaolar incisions Scars are almost never visible

Douglas L. Gervais, MD · Answer

Dear uhfectionate89,

	   Your scars are appropriate for 2 months. They generally get better with time and I inform my patients that scars can take up to one year to fully mature. Your PS is most likely going to use the same scar, but it may be a bit larger when all is said and done. Be sure to ask your PS any of these questions before your surgery. Dr. G.

Kenneth Hughes, MD · Answer

The scars look within normal limits for 2 months after breast augmentation. The scars can be excised at the later surgery. Scars do tend to improve over the first year or so. Kenneth Hughes, MD Los Angeles, CA

Edwin C. Pound, III, MD · Answer

It takes about a year to a year and a half for scars to fully flatten, fade and mature. People will tell you all kinds of magic scar "cures" to use on scars - aloe vera, cocoa butter, Vitamin E, Mederma, Scarguard, etc. Personally, I think all of this is voodoo and time is the big factor. Obviously, if there were one thing that REALLY worked well on scars we would all be using it. Still, I don't discourage patients from trying this stuff. Who knows? At any rate, if you are planning a second surgery, then I suspect that your doctor will simply cut out the old scar so that you only have a single scar in the end. If you want to use these magic scar potions then I would suggest starting them as early as your doctor will allow you to do so.

Kenneth Dembny, II, MD · Answer

Your scars look hypertrophic. They are pink and mildly raised. I would not consider this to be normal healing following augmentation surgery. The expectation is a flat thin scar. Scars may have some red coloration for several months after surgery, but are not raised above the skin surface, when normal healing is taking place. By contrast, a ridge of swelling under the skin and deeper in the tissue is part of normal healing, and may be present for several months as it subsides.
	Raised scars are a risk with any operation, and they often seem to exhibit (mild) inflammation for a more prolonged period of time, when compared to a scar that heals flat. My opinion would be that if left alone your scars will not flatten and improve. These scars may be improved with scar massage, application of silicone gel sheeting, and/or the injection of a corticosteroid.

	When you have your re-operation your surgeon will excise the scar you have now. So, if the appearance of the scar remains unchanged, it will be removed at that time. You may want to ask your surgeon if s/he has an idea why the scar has healed in a raised manner. Perhaps measures can be taken to attempt to prevent if from happening again following your revision surgery.

	I don’t know your body size, but if you are average size, I would ask that you think twice about exchanging your implants for (such a large) 700cc size. There is significant morbidity associated with large implants: excessive skin stretching, the occurrence of stretch marks, thinning of the skin, implant malposition and descent below the level of the inframammary crease, wrinkling and rippling, breast ptosis, pseudoptosis, breast gland atrophy, etc. Some of these may occur soon after surgery, while others may occur in a more delayed fashion or over several years. Either way, these are sources of patient dissatisfaction, and the surgical correction of these problems is not always easy.

	Best wishes, Ken Dembny

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