Too much scar for revision? (Photo)

Question

54 yrs old, mastopexy with moderate profile implants 375/410 on 3/5/2021. Surgical bra too tight per PS and caused blood flow problem with wound issue that lasted months. Been doing Silagen scar gel but puckering of tissue next to scar is lumpy and I'll be moving to a different state and didn't know if it's worth thinking of a scar revision. Should I leave well enough alone or would you recommend to a new patient to do a scar revision, and if so, would implants have to be removed?

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

Jason Emer, MD · Answer

A formal consultation is needed to discuss your full medical history and the best next steps.  Generally speaking, scars can be improved with a combination of surgery and/or lasers and microneedling with PRP. Below is a more detailed reference list of the treatments available. I recommend getting a formal evaluation with a scarring expert to determine which is best for your specific case. Best, Dr. Emer

Daniel Barrett, MD · Answer

Dear Intuitive791748,
I understand you are concerned with the appearance of your scars. As your scars heal, it should flatten out and lighten. Loss of pigmentation or hyperpigmentation may also be experienced but will resolve over time. Always follow your surgeon's post operative care instructions when it comes to scar management to avoid any complications like infection and for 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

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