Should I Use Silicone Gel Sheets After Breast Lift?

Question

I have just had a typical anchor shaped breast uplift 2 weeks ago and am due to start using scar reduction gels. Should I be investing in special silicone sheets to flatten the scars and achieve best results? The scars are still lumpy but is the pressure of the support sports bra enough to flatten?

Larry S. Nichter, MD, MS, FACS · Answer

Best Scar Management is important to minimize or completely hide from view, the telltale signs of your surgery—namely, scars. Both you and your surgeon want you to have the most minimal scarring possible. There are many possible causes for scars that are enlarged or not healing well. Unsightly scars are most commonly due to genetics, underlying medical conditions, or improper scar/wound care. The last part is very important and patients can make a noticeable difference in their scars’ appearance by following best scar management practices. Here are some simple tips.Scar Management tips:Minimize tension on the scar. Steri-Strips and/or surgical tape are often placed in non-hair bearing areas at the time of surgery to minimize tension and keep pressure over the scar.  This minimizes the  stress that  can pull the scar apart (dehiscence) creating a wound and  delaying healing time, and can make the scar wider, or more “ropy”. In the first few weeks after surgery, I recommend the use of Embrace Scar Therapy which is an adherent silicone sheeting pre-stretched when applied so as to offload tension on the scar.Keep your incision site/scar clean to prevent infection. Follow your surgeon’s wound care instructions to the letter with out modification. Never apply different products then recommended without first discussing them with your surgeon. This is especially important during the first few weeks. If there are any signs of infection, contact your surgeon’s office right away and/or see your doctor or his nurse immediately. Typical signs of infection may include redness outside the immediate incision site, asymmetric swelling, and drainage, of pus, fever, chills, and “feeling sick”.Protect your scars from the sun. Staying out of the sun is the best advice. Minimal exposure to sunlight is prevents hyperpigmentation (permanently turning brown) and other problems that can make the scar more noticeable. Sunscreen, at least 30 SPF and an overlying make camouflage make up additionally protects the scar from the suns harmful rays. This advice is especially important the first year following your surgery.Use specific scar maturation products recommended by your surgeon. Patients seem to have their own opinions on this touting everything from Pure Vit E, Coco butter, to Aloe Vera, etc but most have minimal benefit other than keeping the scar hydrated. Although hydration is important there are better, scientifically studied products with greater efficacy. Most of the scientific articles written about this subject indicate that topical silicone gel or silicone sheets work the best. The best product available in my opinion is the Embrace Scar Therapy System by Neodyne BioSciences, Inc. available in many surgeons’ offices. Essentially this is an adherent silicone sheeting pre-stretched when applied so as to offload tension on the scar. For areas that are not applicable for this product (e.g. smaller areas or on the face), I prefer BioCorneum or Kelo-Cote products There are a lot of products to choose from, but silicone should be one of the key ingredients. Although Mederma, an onion extract derivative active ingredient rather than mainly silicone based may help, primarily silicone based products are better and many also contain other ingredients that may be synergistic (hydrocortisone or other steroid, Vitamin E, Sunscreen, etc).. If the reader has problems obtaining these they can call my office. Patient compliance is also critical – use often and according to directions or it will not work optimally. NEVER apply products without first discussing them with your surgeon.Monitor to make sure your scar is progressing optimally. Keep your scheduled follow-up appointments with your surgeon to verify that your scars are maturing as expected.  Occasionally if indicated you may need a topical steroid preparation or even a series of  injections (5-FU and/or Steroids) or laser treatments  to treat or  prevent scar hypertrophy or keloid formation (red raised scars), or other topical medicines to treat post inflammatory hyperpigmentation (brown scars) with prescription creams and possible laser treatments.

Young R. Cho, MD, PhD · Answer

Thank you for your question. Breast incisions can be managed using a multimodal approach:1) Scar massage - starting as soon as the surgical dressings come off and the incisions are sealed2) Silicone sheets or scar gels for about six months to year3) Embrace - a tension reducing dressing for the first 2 months4) Fractionated lasers to help blend the scar into the background - done as a series, starting about 4 weeks after surgery and repeated every four weeks for six months.5) Sunscreen to prevent the scars from darkening

Lewis Albert Andres, MD · Answer

Hello!  Thank you for your question. It is common for scars to fully mature for up to a year. In the meantime, there are a few things that may help to ameliorate your incision/scar. The most proven (as well as cheapest) modality is simple scar massage. Applying pressure and massaging the well-healed scar has been shown to improve the appearance as it breaks up the scar tissue, hopefully producing the finest scar as possible. Other things that have been shown to add some benefit are silicone sheets, hydration, and topical steroids. In addition, avoidance of direct sunlight to the incision will significantly help the appearance as they tend to discolor with UV light during the healing process. If unsightly scars are still present after approximately a year's time, other things that your surgeon may consider are intralesional steroid injections, laser, or just surgical revision of the scar itself. Hope that this helps! Best wishes for a wonderful result!

Douglas L. Gervais, MD · Answer

Using silicone sheets and gels can significantly reduce scar thickness and width. We frequently use both products. I would be certain that the incisions are completely sealed (no cracks, scabs or openings) before using the gels or sheets. Good luck.

William Bruno, MD · Answer

I would recommend using both the gel and the silicone sheets if possible. Most patients can tolerate the sheets at   night and use the gel during the day. The manufacturer of the product indicates that the sheets may work slightly better than the gel alone because the sheets apply direct pressure to the scar. As long as you use some type of silicone product for the first several months after surgery, you should have a very reasonable scar.

	Best wishes,

	Dr.Bruno

Bill Kortesis, MD · Answer

I routinely use silicone sheets for difficult scars and found them to work well. The silicone sheets can decrease the thickness and color of the scar. I also routinely use scar creams to help decrease scar formation.

Tom J. Pousti, MD · Answer

Thank you for the question.

I would suggest that you check with your plastic surgeon for his/her preferences regarding incision line management.

In my practice we use silicone sheeting as well as silicone gel routinely.

Best wishes.

Steven Wallach, MD · Answer

I am not a great proponent of allt he scar reduction treatments. In most cases, patients do not need anything to treat scars and they will heal fine. But, one of the only things that has been shown to help problematic scars, is silicone sheets. Ask yoru doctor his preference.

Jacob Freiman, MD, FACS · Answer

Placing silicone gel or sheeting on wounds is proven to decrease the thickness and width of scars thanks to decreasing collagen deposition by fibroblasts. I use Biocornium (no disclosures) on my patients because it has an spf 30. If you can tolerate the sheeting, use it. My patients complaint that it is difficult to clean.

Michael Hueneke, MD (retired) · Answer

Sheeting is the best therapy for scar reduction and there are a number of companies that produce them

Should I Use Silicone Gel Sheets After Breast Lift?

Answers (10)

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