Removing Scar Below Crease After Breast Augmentation?

I had a breast augmentation surgery nearly a year ago; in general, I am happy I did it, although there are things I would change now (e.g. I would choose the 'teardrop shape', as I originally planned, rather than round implants that the doctor persuaded me to take). What I hate is how the scar below my right breast appears to have 'slided' below the crease (it seemed to happen gradually, and settled there a month or two after the surgery).

My other scar is also visible but it has stayed in the crease so I do not mind that, as I am aware that it fades with time; this one, however, is really visible, as it is half an inch below the crease, and is making me self-conscious. Is there a way to help with this? (I did use cosmetics - 6 weeks after surgery, I started Dermatix cream as suggested by my doctor. After that, I used silicone sheets, and now I am using StriVectrin cream since I read that people had good experience with it in scar reduction.)

Would laser be the solution here? If so, could the heat that the laser develops represent a danger for the implant? I am thankful for all answers, as this is really beginning to bother me!

Doctor Answers 11

Discuss your concerns with your plastic surgeon

I would recommend that you return to your treating plastic surgeon to discuss your concerns. Unfortunately, you did not provide frontal view pictures, so it is hard to give specific recommendations. If the implant on the affected side appears to be at a higher level than the opposite side, then you may see improvement with the position of the scar by lowering that implant. A scar revision may be performed at the same time.

Englewood Plastic Surgeon

Scar Visibility Secondary To Implant Malposition

It's reasonable to assume that your inframammary incisions were placed at the same level relative to your nipple areola complexes and breast mounds at the time of surgery. This suggests that your right breast implant has migrated superiorly. This frequently occurs with unilateral capsular contractures.

Although this scenario is impossible to confirm without additional history, pictures and a physical examination, your current history suggests this is a strong possibility.

Under these circumstances, lowering the breast implant pocket might hide the scar. If the breast implants are properly positioned, simple scar revision still represents a viable alternative.

It's important to discuss your situation with your plastic surgeon. Your surgeon should be able to evaluate your scar and formulate a treatment plan that addresses your anatomic findings and achieves your aesthetic goals.

Breast implant scar incision to low on chest beneath implant

Unfortunately scars can never be made invisible only improved or concealed. IF your breast implants are in symmetric positions there are no ways to practically raise the scar. However, I suspect you implant capsule has contracted causing the scar to appear relatively lower, In this instance a capsulotomy could lower the scar. 

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 72 reviews

Maybe Scar Revision

From the looks of your scar it is wide and white. If the level of your breasts is OK (meaning lowering the implants is not a good option,) I would cossider a simple scar revision on the side that bothers you. The scars in inframammary breast implant cases frequently have problems probably from rubbing against bra wear over time.

Best Regards.

John P. Di Saia, MD
Orange Plastic Surgeon
5.0 out of 5 stars 25 reviews

Scar below breast

It sounds like the breast capsule may have gotten tighter and the implant has ridden up on the chest for the scar to be so low now.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

Breast augmentation scar can be repositioned

In general, I don't like the crease scar because of positioning issues, occasional hypertrophy, etc.

Since starting to use so many more silicon implants, I have used it more often.

If the implant is where you like it, leave it alone and don't drop it.

Because of what you mention about the implants looking too round for your taste, and the fact that the scar "settled", I believe you had a capsular contracture.

As the capsule contracts, the footprint of the implant on the chest wall decreases, thus the bottom of the implant appears to elevate relative to the scar.

Depending on what you want, you may need a capsular release, or a repositioning of the scar.

I have repositioned crease scars, it is done under a local anesthetic.

Ricardo L. Rodriguez, MD
Baltimore Plastic Surgeon
4.4 out of 5 stars 88 reviews

Implant position may help

It seems that the implant may be too high from where the incision was placed. If that is the case, lowering the device would make the scar less conspicous.

Michael S. Beckenstein, MD
Birmingham Plastic Surgeon
4.9 out of 5 stars 18 reviews

May need to lower the crease of the right breast

Accurate planning helps to get the scar to lie directly in the crease under the breast. It is possible that your scar was originally in the crease then gradually seemed to drop drop down. The fact is the it may be the implant itself may be ridding up. It would be important to know if the folds under each breast are symmetric and at the same level. If the crease under the right breast is higher than the left then the implant can be lowered. This will get the incision into the correct position. This procedure is called a capsulotomy.

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 16 reviews

There are several options

Unfortunately your scar ended up below your fold. Ideally, it should have been right in the fold. Usually, if there is an estimation problem, the scar ends up a little above the fold. At this point, you have several options. First you can have a surgery to lower the implant pocket to allow the breast to rest at the level of the scar. You should also have this done on the other side, but this will put that scar above the fold. Alternatively, you can switch to a higher profile, larger implant. This will pull up the skin and likely place the scar at the level of the fold. Third, you could have medical tattooing to match the color of the scar with your surrounding skin. An excellent medical tattoo artist in New York City is Walter Lampeter at

Good luck with your scar.

David Shafer, MD
New York Plastic Surgeon
4.9 out of 5 stars 72 reviews

Reasonable scar...

Your scar, although the photo is slightly out of focus, does not appear to be hypertrophic but merely hypo-pigmented and slightly wide.If your implant is sitting in the correct position and isn't too high, then I would suggest continuing to use coverup cosmetics. This is the least expensive, lowest risk solution. Any surgical scar revision will increase the length of the scar and cannot guarantee a better quality or more constant improved position. Laser, steroids, or creams will not help the quality and may potentially make it worse. If you are happy with your result, take the money and run.

Robin T.W. Yuan, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 10 reviews

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.