What is the best way to care for scars after a breast lift and augmentation in African American patients?

Question

What is the best way to care for scars (for AA patients) on the breast after a lift + augmentation procedure? (Silicone scar sheets/gel, etc.)

Martin Jugenburg, MD · Answer

Hello, thank you for your question. Skin in African americans may be more prone to keloids. When it comes to regular healing process without keloids, than the treatment for scars is similar. We advise first no smoking this can affect the blood supply to the skin and the survival of the skin. Silicone sheets have been proven effective and would speak to your plastic surgeon about when you can start that after your surgery. I also advise limiting activity that can potentially stretch out or put tension on your wounds for the first 6 weeks. After this process of scar maturing for one year. There maybe a pigmentation discoloration typically more visible in African americans, and for that we typically recommend micro pigmentation scar camouflage to help with that. Long term want to wear spf under bathing suits on the the scar. some women have considered microneedling to help with the appearance of scars.

Finny George, MD · Answer

Hi, thank you for sharing your question. Scar care is individualized to each patient and can’t be generalized to everyone based solely on their skin color. With that said, a combination of early massage and silicone gel can be employed in the early post op period to optimize results.

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

Daniel Barrett, MD · Answer

Dear PBawdyy,
I understand your concern. It is best that you consult your plastic surgeon regarding post operative care and management (i.e including massage techniques and timing) specific to your case. Your surgeon knows your condition well and has preferences on when and what to use for faster healing and recovery. Post operative care and management depends on the type of surgery performed and the technique used during surgery among other factors.It is best, however, that you follow your plastic surgeon's advice on post operative care management for a smooth and faster healing and recovery.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

James Knoetgen, III, MD · Answer

Caring for scars after a breast lift and augmentation, especially in African American patients, requires attention to healing, pigmentation, and prevention of hyperpigmentation or keloid formation. Here are some key steps:
1. Follow Post-Op Care Instructions
•	Ensure strict adherence to the surgeon's specific post-operative care plan, including wearing any prescribed compression garments and keeping the incisions clean and dry.
•	Attend follow-up appointments to monitor healing progress.
2. Scar Treatment and Moisturization
•	Moisturizing the skin: Keeping the skin hydrated is crucial for healing. Use gentle, fragrance-free moisturizers to prevent the formation of dry, flaky skin around the incision.
•	Silicone-based products: After the incisions have fully healed (typically 2–3 weeks), silicone sheets or gels can be used. These help reduce the visibility of scars by promoting collagen remodeling and reducing hypertrophic scars (raised scars).
3. Sun Protection
•	Use sunscreen (SPF 30 or higher) on the scars for at least six months after surgery to prevent discoloration from sun exposure.
•	Avoid direct sun exposure to the surgical area, especially during peak hours.
4. Massage Therapy
•	After the incisions have healed, gently massaging the area (with the surgeon’s approval) can improve circulation and soften the scar tissue. This can also help prevent the formation of tight or rigid scar tissue.
5. Topical Treatments for Hyperpigmentation
•	Hydroquinone or other skin-lightening agents can be used cautiously to reduce hyperpigmentation (with the guidance of a dermatologist). However, they should not be applied until the incisions are fully healed to avoid irritation.
•	Vitamin C serums may help lighten dark spots and promote skin regeneration, but consult with a doctor to ensure it’s safe after surgery.
6. Avoiding Keloid Formation
•	In cases where a patient is prone to keloids, a doctor may recommend treatments such as:
o	Steroid injections: To prevent or treat early signs of keloid formation.
o	Pressure garments: Wearing specialized garments that apply pressure to the incision areas may help prevent keloids.
o	Laser therapy: Some doctors recommend laser treatments after healing to flatten scars and reduce discoloration.
7. Patience and Time
•	Scars will continue to mature for up to 12–18 months. Their appearance will evolve over time, becoming softer and less noticeable. Be patient during the healing process and monitor the scars for changes.
It's crucial to work closely with a skilled plastic surgeon familiar with skin types, as they can guide you in selecting the right products and techniques tailored to your specific needs.

Connie Hiers, MD, FACS · Answer

Once the tapes or stitches are removed, there are many scar products that are good. You can use the silicone tapes, or products like Mederma or Scar Guard. Your surgeon can advise you to which ones. Use these products for 6 months.

Eric Maiorino, MD · Answer

For my patients, I tend to recommend aggressive scar massage twice a day by rubbing a skin lotion or scar cream of your choice along the incision lines in small concentric circles to help keep the skin moisturized once the steri-strips (small tape bandages) fall off at the 1-2 week period. During the daytime, silicone strips have also been proven to be beneficial in minimizing the scar and are usually well tolerated by most patients.

What is the best way to care for scars after a breast lift and augmentation in African American patients?

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