What can I do to avoid hypertrophic scars after Breast Augmentation? (photos)

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 found in the below link.

I offer my patients the Embrace Scar system. It is a relatively new product and scientifically supported to improve scarring

I am sorry you have had scar issues with previous breast augmentation. It definitely can be genetic and I have seen your results in several of my asian patients. Going larger  can possibly make the scars worse this time as the tension and the weight will be greater across the incision. Lets assume you have the most meticulous plastic surgery closure. Then we need to address the post operative care with great breast support in an appropriately approved by you PS . Then I would advise to take tension off the incision with some relatively new silicon sheets that you can apply weekly. I have seen improvement in scars over time with the use of silicon sheets and I do believe in this therapy. 

Thank you for your question.Here are some instructions on scar care.

To be sure, see two or more experienced,
board-certified Plastic Surgeons for a complete evaluation to make sure you are
a good candidate and that it is safe for you to have surgery.

I hope this helps.

You have already had some excellent answers from other doctors.I would add the following to what I have read above.1- Steroid injections can be done prophylactically. This means they can be done "before" the scar gets bad. One study showed that three injections (one a month) done after surgery and before it got bad, really worked.The first can be done at surgery!2- The silicone sheets work in my opinion.3- Lasers work too. But get a test patch to make sure your skin doesn't pigment from the laser.I hope this works! It usually helps but doesn't end up with "no scar". It is important to have realistic expectations.Dr. Chris Saunders 

Sorry about your hypertrophic scarring.  Some people are genetically programmed to develop these.  While meticulous surgical technique is imperative, hypertrophic scarring can occur in spite of the best technique.Do not consider laser.  It does not matter what creams or lotions you use, in my opinion.  I also have no confidence in scar gels or silicone patches.  However, I generally have patients begin massaging the scars in about 4 weeks.  Steroid injections are often necessary to control hypertrophic scars/keloids.

Scar issues for different individuals can vary many times due to genetics. Some things can be done to limit risk including no tension, taping, silicone sheeting, etc.. But it may not prevent it from recurring.

Here is what makes scars better:1. Time2. Pressure 3. Massage4. Vitamin E ( controversial)5. Silicone sheeting6. SteroidsTo name a few things. All of the above stimulate an enzyme called collagenase. This enzyme converts early collagen ( Type I) to mature collagen ( Type III). Steroids have some down sides: depigmentation of skin, thinning of dermis, fat atrophy ( thinning of the fat).Silicone sheeting: require application 23 plus hours per day for 3-4-5 months or until the scar flattens and softens, you have to committed to using it.Good LuckStephen M. Davis, MD, FACSGreen Hills Plastic Surgery

These can be frustrating.One factor in unfavorable scarring in tension on the incision, and placing larger implants through the incision is a risk factor.  You have already have HT scars, and are likely to get them again. Kenalog injections is the "gold standard" and that would be my recommendation. The discomfort is usually modest, and can be ameliorated by applying local anesthetic cream an hour before the appointmentj.  Silicone gel is the common ingredient in  scar products, and work in some patients. Lasers have been used with some success. Thanks for your question, all the best. 

Adding more volume stretches tissues and can increase the risk of poor scarring.Trying long lasting suture may help, I would still try silicone gel sheeting postop. I agree that some people heal worse,but I feel tension on the skin is a factor.