What is the best approach to achieve a fuller look while minimizing the chance of developing keloids? (photos)

Unfortunately, keloids are a risk with any surgical procedure, especially in those that are already prone to developing them. There are several options that exist to help minimize the risk of this and your surgeon can discuss those with you. In regards to achieving a fuller looking result, you have two options. One would be using your own tissue and adding volume to the breast with fat grafting which is completed through minimal incisions. The other option would be a breast augmentation with implants completed through the scars you already have. This option would not place any additional scars on the breast. As always it is best to consult with a board certified plastic surgeon in your area to create a custom plan for you.

Your scars look like hypertrophic scars. Difficult to tell with the photos. Keloids are tumors and are often confused with hypertrophic scars. Treatments for hypertrophic scars include Aldera, steroids, and low dose radiation. My choice is Aldera. I perform a test spot on an area out of view. There can be many complication with all of these options and you should make a plan with your plastic surgeon.

Scars are present following any surgery. Your scars appear to be hypertrophic scars and not true keloids. These scars generally occur due to tension on the wound closure or some suture reaction. Upper pole fullness can be achieved with larger implants. Meticulous suture technique will hopefully minimize any excess scarring.

A breast lift takes away tissue and often does lead to a smaller breast. A lift does not address how flat a breast looks (cleavage or upper pole fullness of a breast). A breast augmentation does help with the above problem.
Regarding your keloids, there is not a good solution. If this was your first procedure that resulted in keloids perhaps you can assume that more careful tissue handling would help. Did you use silicone sheets? Injection of Jena log? Introduction of the above modalities can help with your final outcome.
Happy to layer discussion with you as needed. Best of luck with your search.

Type of scars you developed are called hypertrophic scars; they are different from keloid because they do not continue to grow, as keloids do. Unfortunately, it seem to be your own, individual response to injury (surgery). Scars can be modulated, to a certain degree, with an early and prolonged scar management. Your next surgery, augmentation with implant can be done through existing scar. You should considering having a small reduction, to decrease your heavy breast tissue moving south due to a gravity, what happened after your first surgery, most likely. You should discuss all these issues with your surgeon before undergoing next surgery, in detail. Good luck.

Dear dcb3051,
it is hard to tell for sure without an examination. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Thank you for your question. You need a revision breast lift with a breast implant. This will help achieve upper pull fullness. To avoid keloids your surgeon must avoid tension along the skin and meticulous closure technique. However, for patients that are prone to keloids, this may be in unavoidable risk. Your scarring appears to be hypertrophic, and not a keloid now. Some postoperative therapy with steroids and scar treatments can help reduce the scarring. Good luck.

A board-certified plastic surgeon is qualified to address your issues. Board-certified plastic surgeons have spent years of training and have the top level of experience and skill. Seek out a board-certified plastic surgeon for your cosmetic needs.

You can consider a scar revision to improve the appearance of the scars. If you are satisfied with the breast volume but want more upper pole fullness you can consider auto augmentation which uses your own tissue to give more fullness at the top. I've included a video on this approach. If you want more volume overall, augmentation can be performed along with the scar revision.

An augmentation can be done using your existing scars. After surgery, Kenalog injections can be done to help minimize excess scarring. Your photos don't show keloid scars but hypertrophic scars which are easier to deal with and minimize.