Hypertrophic Scars After Breast Lift? (photo)

Hidef protocols can help with keloid and hypertrophic scars on the face and body. Surgery is often not needed if lasers are introduced. 
In our office, we combine treatments starting with topical pre-conditioning of the scars with Plato's Scar Serum for hypertrophy and Melarase PM for pigmentation. Fractional RF, laser, and micro fractional RF can help limit scar growth. Kenalog IIT can also help reduce scar thickness. 
Best, 
Dr. Karamanoukian
Realself100 Surgeon

Recent surgical scars in general can still be improved significantly for most. 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 below link:

Hello! Thank you for your question. 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 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. Hope that this helps! Best wishes for a wonderful result!

Thank you for your pictures.  Your keloids can be revised.  The closure of the scar revision must be tension free.  Tension or pull on the incision can produce wider scars.  

Dr. ES

Hello,

I am sorry you have developed this fairly rare occurrence after your breast lift. These are hypertrophic scars that have formed. There are two avenues you can pursue. The first is a vascular tissue targeting laser, called the V Beam. This is a 'pulsed dye laser' that produces a high energy beam of light that passes through skin to the blood cells in the vessels of the scar.  This laser causes obliteration of the those vessels and a visible reduction in the size and color of the scar.  There is an initial blast of liquid nitrogen prior to each pulse of the laser to decrease discomfort and minimize thermal injury to the skin.    I have been more impressed with this device then the IPL.

The other avenue you could chose is surgical excision of the scars with precise restitching, and long term post operative elastic tape therapy.  Although I feel this can be very effective at producing a fine, non-hypertrophic scar, I always encourage people to try the V Beam first. 

Best of luck!

Many thanks for your question, and I am sorry to see your otherwise good result tainted by your hypertrophic scars. This happens every so often and is a very frustrating problem.

The simplest (and cheapest) thing to do if you are not already doing it, is to moisturise and massage the scars as firmly as possible, for at least 10-minutes every day.

Secondly, I would recommend using silicone gel products on the scars as these will help.

You may also want to discuss with your plastic surgeon having a course of steroid injections into any particularly lumpy areas of the scarring.

Finally, there are other treatments that may help, such as IPL.

Good luck with your treatment.

Hypertrophic scars can very frustrating to treat. Options range from simple silicone sheeting and massage to steroid injections, lasers, and scar revisions. The most common reason for hypertrophic scarring is an increase in tension. However, some patients simply tend to build bigger scars. Attempting to improve with massage and silicone sheeting is a simple first option. If the scar hypertrophy persists after 6 months to a year, a scar revision is recommended.

First you should ask your plastic surgeon about his/her specific recommendations.  I usually start scar massage therapy 5-6 weeks after surgery.  I generally recommend a silicone based scar cream.   But to be honest, its not the cream or ointment that matters, its actually the mechanical massaging of your scars.  The theory is that the mechanical massaging helps to break up "scar tissue."   Continue pressure on your scar has been shown to help as well.  This can also include silicone gel strips.  Please talk to your PS about his/her recommendations.  Best wishes,

Dr. Basu

Houston, TX

I would try conservative therapy suchas kenalog injections.If they do not repsond then I would re excise and inject kenalog at the time of revision.

If the breast lift was soon fairly recently, you should do scar massage with silicone-based cream and avoid Sun.  If it has been over 3 months, steroid injection will help to flatten the scar.  If the surgery has been done over a year, IPL laser can help.  Revision surgery is an option; however, it may recur again.