Follow-up: Options to improve scars after 1 year post-op mastopexy/augmentation? (photos)

Dear Elizabeth_T,
based on your photos, it looks like you might benefit from scar revision surgery. For scars, I close all of my incisions in 5 layers and do not use absorbable sutures because they cause inflammation and worse scarring. I tape all of my incisions in the office visits once a week for six weeks after surgery to improve the appearance. After taping, I start my patients on a scar gel therapy for 3 months that they have to put on their incisions twice daily.
You should discuss your concerns with your plastic surgeon as different surgeons have different approaches in scar management.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

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

Hello, thank you the question and provided photos, based on them you canbenefit from scar revision procedure and your scar can be improved for better appearance. You can use silicone based creat to help them haling faster. For some patients scar might heal a bit late, you should  not be worried for that case. You need to seek an exprienced, professional Surgeon to get the best result.Best Regards,

You may benefit from a scar revision where the scars would be cut out and the incisions re-closed.  We also have seen beautiful results with Silagen which is a silicone based scar cream.  I recommend that you consult with board certified plastic surgeons in your area and be sure to carefully examine their before and after photos to make sure they are able to produce results that you will be happy with.  Best of luck to you!

Hello,Sometimes it best to start over. Looking at your dark and purple scars, that would be what I recommend; these are not amenable to silicone or lasers. This would involve removing all the scars at the level of the skin, and carefully re-sewing them. The difference would be much less tension on the fresh incisions compared to when your breasts were actually lifted. In addition, I would not recommend Embrace as it is way too expensive and not as reliable as an elastic and porous tape like Hypafix. Further, you don't need silicone in the first 6 to 8 weeks, only mechanical support. 

Let your surgeon do the scar revision to get the scars more narrow, then continue once the tapes or sutures are removed with scar products. Avoid all tanning for 6 months or your scars will darken.

Hi and welcome to our forum!
From your photos, I note the presence of broad red scars with a degree of hyperpigmentation.
The operative procedure of mastopexy (breast lift) involves
separation of the skin and soft tissues of the breast from underlying breast
tissue. The skin and soft tissue is then advanced downward and the excess skin
and soft tissue is removed in an inverted "T" fashion. A pocket is created for insertion and placement of a prosthetic implant. If there is impairment of the blood supply to the breast skin and
soft tissue, the segment of the flap the greatest distance from its blood
supply may not receive adequate blood supply (at the junction of the inverted "T" flaps).
The cause of the blood supply impairment can range from effects
of smoking, diabetes mellitus, vascular disease, previous surgery in the
area (disrupting the normal blood supply), infection, or may totally
inapparent.  
If impairment is severe, tissue death may occur. If moderate, adverse scarring may occur.
However, there is no magic to the "one year rule" of scar maturation. It may take another year or longer for the scar to fully mature. There is still a degree of redness suggesting that the hypervascularity of healing has not yet ceased. The hyperpigmentation will most likely persist after complete healing. Steroid injections may make scars broad and cause pigmentation alteration and should be used with caution.
Options include further watchful waiting for further spontaneous improvement, accepting the scar "as is", or scar revision. The area has since revascularized after the previous procedure, so blood supply issues should not be paramount.
How do your other scars heal? Some individuals tend to create thicker scars than others. The majority of patients will experience improvement. If you have a thick scar history and scars are of great concern to you, consider partial scar revision of a short segment to determine if it offers improvement.
Best wishes...