What would be the best scar revision for my post-surgery areola scars? (Photos)

Question

Had my mastopexy surgery for tuberous breasts two and a half years ago now. Was conscious of the scarring as it’s visible through my clothes as they are raised. The areolas also have a sort of ‘puckered’ look. What advice would you give on ways to flatten the scars and relax them?

Anil R. Shah, MD · Answer

Hello! My name is Jessica, I am a physician assistant, and one of the providers at Aesthetic Skin in Winnetka and Chicago. This is a great question. For addressing visible scarring and the puckered appearance of your areolas after mastopexy, CO2 laser resurfacing can be an effective treatment option. This procedure utilizes fractional CO2 laser technology to target the outer layers of the skin, promoting collagen remodeling and encouraging the regeneration of healthier skin. By creating micro-injuries in the treated area, the laser stimulates the body’s natural healing processes, which can lead to improved texture and reduced visibility of scars over time. CO2 laser resurfacing can be particularly beneficial for flattening raised scars and softening their appearance. It helps to smooth out irregularities and can significantly improve the overall aesthetic of the scarred area. The treatment typically requires some downtime, as the skin may appear red and feel sensitive post-procedure, but the long-term results can be quite rewarding. I hope this helps and best of luck!

Chet Mays, MD · Answer

Thank you for your inquiry! Scar creams can be used on scars to minimize appearance as well as silicone scar sheets. Lasers such as Microneedling can also be performed to minimize appearance as well. We would love to see you in person or virtually to discuss treatment options or schedule a consult with a licensed aesthetician.

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

As a professional assistant to Dr. Anna Chacon, a dermatologist, I can provide some general advice on scar revision that might be helpful. However, please consult directly with a qualified dermatologist or plastic surgeon for personalized recommendations.

For raised and puckered areola scars following mastopexy surgery, there are several potential treatment options that you might consider:

Silicone Gel or Sheets: These can be applied to the scars to help flatten and soften them over time. They are often used as an initial treatment for raised scars.

Corticosteroid Injections: These can be injected directly into the scar tissue to reduce inflammation and flatten the scars. They are particularly useful for hypertrophic or keloid scars.

Laser Therapy: Different types of lasers, such as fractional laser therapy, can be effective in reducing scar appearance by stimulating collagen remodeling and reducing redness.

Microneedling: This procedure involves using fine needles to create micro-injuries in the skin, which can promote collagen production and improve the texture of scars.

Surgical Revision: In some cases, surgical scar revision may be recommended to improve the appearance of the scars. This would involve removing the old scar and re-suturing the area to achieve a more aesthetically pleasing result.

Topical Treatments: Prescription-strength creams, such as those containing retinoids or other active ingredients, can help improve scar texture and appearance over time.

Massage Therapy: Regularly massaging the scar tissue can sometimes help to break down the dense bands of collagen and improve the overall appearance of the scars.

It's important to discuss these options with your dermatologist or plastic surgeon, who can evaluate your specific case and recommend the best course of action based on your skin type and the characteristics of your scars.

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