Revision to areola scars after kenalog injection?

Question

Hello, I had bilateral scar revision to my areolas a year ago. The scars widened and I received a kenalog injection to the areola scar on my left breast about 6 weeks ago (my right areola scar is not as bad and I didn't get an injection on that side). Anyhow, it's clear to me that this injection was not helpful and maybe even made things worse. My question is, how long after a kenalog injection to an areola scar could a revision happen? I think my best option is to just redo both areolas but I wasn't sure if the kenalog is still doing its thing or if it's safe to excise that tissue at 6 weeks post injection. Thank you

Raffy Karamanoukian, MD, FACS · Answer

Our office has many different treatments for scars depending on the depth of atrophy or hypertrophy. Scars require a combination approach using our HI DEF protocol which uses a combination of lasers, topical scar modulation, and RF treatments to pixelate scars, improve contour, reduce hyperpigmentation, and improve the visibility of the scars so that they are no longer visible in ambient light. Everyone has a unique pattern of scarring and we employ our HIDEF technique to improve texture, color, contour, and topography. We often use a combination of treatments that begin with a careful examination to examine the micro texturing of the acne scars. Atrophic scars and indented  scars can benefit from injectable fillers such as Radiesse, Sculptra, and Restylane with or without subcision to remove tethered scars and atrophic depression. Hyper-redness in scars can be improved with V beam laser, Excel V, BBL, IPL, and Venus RF to improve  the redness and reduce the visibility of deep scars. Fractional Thulium laser and clear & brilliant can also reduce the inflammation and redness of the scar when combined with topical therapy. Fractional lasers such as Fraxel, erbium, and CO2 laser can be combined with radio frequency and also fractional RF to improve textual issues and microtopography. Subcision and TCA cross are also used for deep ice pick scars and narrow valley scars in order to improve the micro texture.  Above all, our combination approach with our clinical nurses and board-certified plastic surgeons can improve the quality of your skin by using at home Melarase creams combined with PRP treatments in our office to improve your skin quality and tone. I recommend getting a formal evaluation with an experienced team of experts in order to reduce your scarring.

Finally, hyperpigmentation of scars can be improved with at-home Melarase AM, Melarase PM, and Melapads to help reduce active PIH and melanin deposition.

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Anna Chacon, MD, FAAD · Answer

Thank you for sharing your concerns. Kenalog (triamcinolone acetonide) injections are commonly used to treat hypertrophic scars and keloids by reducing inflammation and scar tissue. However, results can vary, and sometimes the appearance of the scar can change in unexpected ways.

Here are some considerations regarding scar revision timing after a Kenalog injection:

Healing Period:
Typically, it is recommended to wait at least 3 to 6 months after a Kenalog injection before considering surgical scar revision. This allows time for the full effects of the steroid to manifest and for the tissue to stabilize.

Consultation with a Specialist:
It is important to consult with a board-certified plastic surgeon or dermatologist who specializes in scar management. They can assess the current state of your scars and determine the best course of action.

Evaluation of Tissue Condition:
The condition of the tissue post-injection is crucial. The specialist will evaluate whether the tissue has sufficiently recovered from the effects of the steroid, as Kenalog can thin the skin and affect healing.

Alternative Treatments:
Before proceeding with another surgical revision, consider discussing other non-surgical options that might improve the appearance of the scar, such as laser therapy, silicone gel sheets, or other topical treatments.

Personalized Plan:
Every individual's healing process is unique, and a personalized treatment plan is essential to achieving the best outcomes.

Ultimately, a thorough evaluation by a qualified professional will help determine the appropriate timing and method for any further intervention.

Rajaie Hazboun, MD, MBA · Answer

Thank you for posting your question here!My answer will be based on the limited information provided, for a detailed and personalized plan please consult with your surgeon in person.
It is hard for me to weigh in without photos , but that being said , kenalog usually works for hypertrophic scars and sometimes for keloids , but if your issue is widening , kenalog will not help and might even harm the situation , widening happens secondary to tension on the wound. around the areola this is usually addressed by placing a permanent circumareolar suture (most commonly a goretex suture) this will counteract the tension while the wound heals and decreases the chances of areolar widening and scar widening.I hope this helps, best of luck!

Revision to areola scars after kenalog injection?

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Revision to areola scars after kenalog injection?

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