Can using hydroquinone prevent pigmentation of lift scars?

Hi, thank you for sharing your question. There are a number of things that can be done to reduce the appearance of scars. Hydroquinone used post-op is one such modality. It is not necessary in all patients and will not effective if used before surgery for surgical scars. I hope this helps. Best of luck!

Plastic surgery scars require attention after surgery so that they remain cosmetically-appealing and barely noticeable. In our office, we use a protocol for scars that minimizes their activity in the 6-8 weeks after surgery. If you have late plastic surgery scars, you may also require laser and RF therapy to help reduce the longterm effects of the scarring. Keloids, hypertrophic scars, widened scars, red scars, and hyperpigmented scars all require scar modulation with topical creams followed by lasers and RF therapy. Topical skincare should be directed to a specific need, whether for pigmentation or hypertrophy and our office can guide you through the process to obtain the correct Plato’s Scar cream or Melarase cream for hypertrophy and discoloration. In terms of lasers, we would employ the vbeam laser for redness, Venus Viva RF, PRP microneedling, chemical peels, and Morpheus 8, fractional erbium, or fractional co2. All of these have their individual benefits. Most of all, we recommend you visit a solid plastic surgeon who understands surgical scar revision, laser therapy, and RF therapy for scars.

Best,
Dr. Karamanoukian
Realself100 Surgeon

There are several things to minimize scarring.  During breast lift layered closure and tension free followed by taping the scars for the early Postoperative period.  Then I recommend silicone topically to reduced the risk of keloids.  Patients predisposed to hyperpigmentation, maybe prescribed Hydroquinone but not used preoperatively.

Dear mariacatherine,
for scars, I close all of my incisions in 5 layers and do not use absorbable sutures because they cause inflammation and worse scarring. I tape all of my incisions in the office visits once a week for six weeks after surgery to improve the appearance. After taping, I start my patients on a scar gel therapy for 3 months that they have to put on their incisions twice daily.  Hydroquinone can be used to improve hyperpigmentation.You should discuss your concerns with your plastic surgeon as different surgeons have different approaches in scar management.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

I frequently use hydroquinone after surgery (not before) in women who are susceptible to pigmented scars. It works well for the vertical limb scar starting about 3 weeks post-op, twice per day for 3 months.

I do not recommend using Hydroquinine prior to surgery and immediately after surgery. Scar products will be helpful initially once the tapes and sutures are removed, and completely avoiding tanning. Later, if the scars show darkening, you could try it, but will need to be very careful how it is placed on the skin. It is also a product that is not used for long term.

While a small amount of very focal hydroquinone can help scars fade post-operatively, I do not believe pre-operative treatment will help reduce your amount of scarring post operatively. The danger even in using it post operatively is that it can lighten the skin surrounding the scar, so not only do you have a lighter scar, but you have a halo of lighter normal skin around that, surrounded by normal colored skin. For scar fading, other agents such as silicone gel or strips and even laser (after the appropriate amount of time has passed) are more effective and predictable. 

Thank you for your question.  While hydroquinone would not be something to pre-treat your breasts with, it could possibly be something to consider after surgery and only if warranted.  Hydroquinone is a powerful agent and one that should not be used pre-operatively simply in anticipation of pigmented scarring.  Most patients following a breast lift or breast reduction are pleasantly surprised to find that the incisions often heal beautifully and into thin lines.  In my opinion, the best ways to reduce the chance of scarring is ensuring a tension-free closure and using a silicone based scar treatment or tape post-operatively.  Every patient heals differently and scarring is always a risk, so I would encourage you to bring these concerns to the attention of your board certified plastic surgeon and learn of their recommendation and approach for minimizing their appearance.  I wish you all my best and I hope that this answer has been helpful to you.