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

Question

2 years ago, i had a breast lift. However, I am not satified with the keliods in which I developed around the aroreolas. I am also not happy with the lack of fulliness. It appears my breast is smaller than before the lift. I would like to have breast augmentation, but afraid of developing more keliods. Whats is the best way to achieve a fuller look and to minimize Keliods?

Jason D. Hehr, MD, FACS · Answer

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.

I. Nick Vial, MD · Answer

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.

Robert M. Wald, Jr., MD · Answer

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.

David Parizh, DO · Answer

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.

Zoran Potparic, MD · Answer

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.

Daniel Barrett, MD · Answer

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

Wess Cohen, MD · Answer

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.

David Plank, MD · Answer

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.

Camille Cash, MD · Answer

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.

Connie Hiers, MD, FACS · Answer

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.

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

Answers (12)

More Breast Augmentation Questions

WE SEND PRETTY
EMAILS

Answers (12)

More Breast Augmentation Questions

Can nipple sensitivity be returned through implant removal or other procedures? 2 years post op

Are my implants bottoming out and would I benefit from a revision? (photos)

Scars after Breast Augmentation - Is this something that can happen or that happens often?

8 months post op, one breast is harder than the other. What could be causing this?

1 year post breast augmentation, what can I do to achieve my desired look and address Cleavage and upper pole? (photos)

Which size of implant would deliver natural results with upper pole volume? (photos)

WE SEND PRETTY EMAILS

WE SEND PRETTY
EMAILS