Risk of Keloids/hypertrophic Scarring from Breast Reduction?

I’m having a breast reduction in a month and am slightly worried about keloids - I haven’t gotten any before, but I also haven’t had surgery before. There's no history of keloids in my family. I do have super sensitive skin though and had some small scarring when my ears were pierced (the scars went away in a year though). I’ve gotten a very small tattoo in my bra area and it healed fine - could this mean there’s a smaller chance I’ll keloid/get hypertrophic scarring from a breast reduction?

Doctor Answers 5

Scarring after Breast Reduction

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

If you have not "Keloided" by now, you should not do so. A Keloid is a problem that occurs in certain people with a genetic tendency to do so. With what you have had, you should have done so if you were going to. A hypertrophic scar, on the other hand, can happen to anyone. It is most frequent when fast absorbing sutures are used below the skin and skin sutures are removed soon after surgery. When more permanent sutures that maintain their integrity for a number of months are used below the skin as the only sutures used, the risk of hypertrophic scarring decreases to negligible. In breast reduction, I also remove the surface of the skin leaving the thicker dermis as reinforcement to support the scar and further reduce the risk of a bad scar. Ask your surgeon what he/she does to reduce the chance you will have an unattractive scar after the procedure and look at pictures of the postoperative results.


Highlands Plastic Surgeon

Keloids/Hypertrophic Scarring from Breast Reduction

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

It is often difficult to determine preoperatively who will have keloid or hypertrophic scars following breast reduction. Keloid scars and hypertrophic scars are two different issues. Keloid scars are the result of an abnormal scar response in which the scar expands outside of the area of injury.and then does not regress spontaneously. Keloids will tend to recur after excision. Hypertrophic scars are red and raised, but do not expand outside of the area of injury.

The occurence of a keloid scar has a genetic component - people who have family members with keloid scars have an increased chance of healing with a keloid scar. In my experience some patients will form keloid scars in some area of their bodies, but not others. In some patients closing a surgical wound with meticulous technique will still result in a keloid scar.

Hypertrophic scars are not thought to have a genetic component and are likely to improve with excision and reclosure. Proper surgical technique with a tension free closure minimizes the risk of hypertrophic scar.


David P. Stapenhorst, MD
Sugar Land Plastic Surgeon

Keloidal or hypertrophic scarring

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Keloids and hypertrophic scars are not the same. Keloids are actual masses which form in scar tissue; scar hypertrophy denotes a red, spread and inflamed scar. If you have not keloided after ear piercing, then in all likelihood you will not form keloids from breast reduction. Scar hypertrophy risk can be reduced by careful surgical closure, regular followup and treatments which range from silicone sheeting to Kenalog injections into the scars. Family history is also important. African-American patients are at higher risk of keloiding than fair skinned patients.

Keloiding after breast reduction

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Most people over the age of 20 know whether or not they are prone to keloids.  Regardless of having prior surgery, people who keloid can form these tumors from a fall, cut, peircing, or tattoo.  So it is in your favor that this has not happened to you.  I would discuss your concerns with your plastic surgeon but in most cases the breasts heal very nicely.  I hope this helps you.

Kindest regards,

Neil J. Zemmel

Hypertrophic or Keloid Scarring Breast Reduction

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

History is very important regarding chances of keloid scarring but is not the only factor.  Anyone may form hypertrophic or keloid scarring.  The goal is to minimize the risk.  That involves patient selection, good surgical technique and good post operative care.  Discuss this with your surgeon.

Albert Dabbah, MD
Boca Raton Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.