When can one safely use chemical peels, hydroquinone, laser treatments on breast augmentation scar?

I am shy of 5 weeks post op. If I would like to improve the quality of my scar besides using silicone gel & sheets, when can one safely do the other measures?

Doctor Answers 5

Time will improve the quality of your scars - 6-18 months is needed

Thank you for your question.

It is very important that you follow your surgeon’s post-operative instructions and advice as we all have differences in opinion and management of scars.

That being said, you would benefit from some information about scarring.

First, there is no treatment that can remove a scar, but its healing and improvement can be accelerated. If left alone, scars will fully mature both outside and inside in about 1-2 years as part of the normal healing process. Fully matured refers to a flat, non-red scar. Initially, the scar would become raised, red due to inflammation and blood collection, and then slowly start to recover. Sometimes it can become hyper-pigmented within 6-8 weeks, if abraded. The build-up of collagen helps in formation and healing of scars – and around 6-8 weeks, scars become more noticeable and thick. As time progresses, collagen is placed along lines of tension, and the re-arrangement of collagen beneath the scars makes the scars smaller and fine. If we only consider the visible scar, and not the portion beneath the skin, then scars would seem matured in anywhere from 6-18 months. I would advise that you allow normal scar maturation before laser scar treatments.

The purpose of laser treatments such as pulse dye laser treatments, or chemical peels is to reduce the redness of scars.  The treatments should be initiated weeks to months after the scar develops and would require multiple treatments. Research shows that the laser treatments right after suture removal is safe. However, it is not effective with a single treatment, but may require at least 2-3 treatments.

The problem with these treatments is that the redness is due to both hypervascularity of healing scars, and the myofibroblasts (fibrous cells that are red) that are working to shrink the scar. This will not only delay the full maturation, but also be a waste of your money because you will be paying for something that would happen naturally by itself in a few months.

The standard of practice is to limit sun exposure to the scars, and to tape the wound after applying silicone gel sheets on the wounds. Research shows that topical silicone sheets significantly improve hypertrophic scars and keloids when applied at least four hours per day. In terms of regular healing of scars, silicone gel sheeting can flatten the scar, make it less red, less hard, improve elasticity, reduces any pain and itching especially after 6 months of treatment. However, sheets have to be washed carefully to prevent complication such as rashes and infection.

Again, please follow-up with your surgeon to make sure your breasts and scars are healing beautifully.

Hope this helps


Toronto Plastic Surgeon
4.9 out of 5 stars 450 reviews

Breast Augmentation/Breast Implants/Anatomic Gummy Bear Implants/ Silicone Implants/Breast Implant Revision

I appreciate your question.

I would recommend that you discuss this question with your surgeon as every surgeon has their own respective post op protocol for his/her patients.  Your surgeon is your best resource as he/she is most familiar with your medical history and how you are healing at this time.

The best way to assess and give true advice would be an in-person exam.

Please see a board-certified plastic surgeon that specializes in aesthetic and restorative plastic surgery.

Best of luck!

Dr. Schwartz

Board Certified Plastic Surgeon

#RealSelf100Surgeon

Jaime S. Schwartz, MD, FACS
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 83 reviews

BA scars heal well without much intervention

Hi bellelewis1. In the first 3 months, silicone sheeting can be very effective for helping a scar flatten and soften.  With time, pigmentation lessens as well on its own without further intervention.  It is likely that if you are too aggressive, the scar will re-pigment and potentially become firm & raised from the inflammation.  In my experience, peels, hydroquinone, laser tx etc are not necessary and BA scars are barely visible 6-12 months postoperatively in most patients. You might consider PRP injections to deliver more growth factors directly into the scar.  Steroid injections can help soften & flatten scars as well.  These are uncommon, so remember your PS will be your best guide as he/she is assessing your healing actively. Best wishes,

Vaishali B. Doolabh, MD, FACS
Jacksonville Plastic Surgeon
4.9 out of 5 stars 33 reviews

Scar

Your surgeon, who has examined you and knows how well you are healing, will be the best one to tell you when you can use other products than those designed for scars. If you avoid tanning, you probably will not need hydroquinone.

Connie Hiers, MD
San Antonio Plastic Surgeon
4.6 out of 5 stars 13 reviews

Scars after BA

The treatment of cosmetic surgery scars on the breast or otherwise is very Dr. specific and you might want to ask your physician what their thoughts are on this topic. For our patients, we begin silicone gel scar creams starting at two weeks post surgery. If drug delivery with lasers for hypertrophic scars is done, we start at six weeks postoperatively. For redness, treated with intense pulse light, we might start a little earlier. Congratulations on your surgery.

Marc J. Salzman, MD, FACS
Louisville Plastic Surgeon
4.7 out of 5 stars 52 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.