Abnormal breast reduction scarring? (Photo)

Question

I had a breast reduction Sept 22 (8 months ago). I have noticed the scars are still very painful (I can’t have showers without covering the scars). They feel raised and seem to me like they are more pronounced than before. The surgeon didn’t mention anything about abnormal scaring at the follow ups after the procedure. Will these fade (I’m using bio-oil as recommended)? Can something help the pain or reduce the look of these scars?

James N. Romanelli, MD, FACS · Answer

Dear easygoing

Scars vary so much from one patient to another.  It seems to be related to patient factors.  Your scars can use attention.  In my experience silicone tape and gel are more effective than bio-oil alone.   Steroid injections and laser may be helpful as wel.

Don't suffer untreated.  See your surgeon to explore options.

Best of Luck, Dr. Jim Romanelli

Jonathan Heistein, MD · Answer

Hi. Your scars look like hypertrophic scars.  Talk to your surgeon about using a prescription strength steroid cream to see if it will help.  This doesn’t always work, but it’s easy to try and very little potential downside.  It’s a good first step.  Best of luck!

Afet Oncel Bozkurt, MD, FEBOPRAS · Answer

Hello, this kind of scarring seems too much, but do you have keloid prone skin? If your skin produces keloid during healing, it may cause scars like this

Natasha Van Zyl, MBChB, FRACS · Answer

Firstly, I would like to say that you seem to have a lovely shape from your breast reduction which you must be pleased about. It is normal in the first 3 to 6 months of healing to have scars that are thicker and slightly coloured. This is because the first collagen that is laid down to heal a wound is a more of a temporary type of collagen which is laid down quickly. With time the body reabsorbs this collagen and replaces it with a more mature collagen type which is pale and flat. Are as you are still relatively early in the scar maturation process, I would recommend trying a silicone scar tape. These tapes should be worn on your scars all the time (taking them off for showering and swimming) and used for at least 3 to 4 months or until the scar becomes less itchy and painful and has flattened out and become pale. Hopefully they will be looking a lot better by the time you get to September of this year. 
However, if the scar does not improve and is still looking the way it looks now one year or more after surgery then you may have what is called hypertrophic scarring. A hypertrophic scar is a thick, raised, coloured scar that is an abnormal response to wound healing. Hypertrophic scars can occur when the wound has healed without complication but also can occur if there has been some issue with wound healing or infection or if the wound is closed under some tension. Treatment options for hypertrophic scars include injection with steroid, silicone gel pads and surgical scar revision.

Ira H. Rex III, MD · Answer

everybody scars differently and this is usually difficult to anticipate. For painful scars, sometimes a week steroid injection helps. Otherwise, often the best thing to do is wait for the scars to lighten. They often become almost white. This is often a very acceptable result. The elevated scars often flatten out. Although the first impulse is often to do a surgical scar revision, usually over to or three years there is  acceptable improvement. Surgery may increase the scarring, but still may be considered in some situations.

Gary M. Horndeski, MD · Answer

I recommend you undergo a scar revision.  The scars can be excised and closed without less tension on the closure.

Best Wishes,

Gary Horndeski, M.D.

Scott C. Lindsay, DO · Answer

Hello and thank you for your question.
 Scars can take up to a year to heal/fade. You can use silicone sheeting, scar gel, or lasers to help diminish and lighten the scars. Reach out to your surgeon with these concerns.  Best wishes!

Daniel Barrett, MD · Answer

Dear Easygoing398478,
I understand you are concerned with the appearance of your scars. As your scars heal, it should flatten out and lighten. Loss of pigmentation or hyperpigmentation may also be experienced but will resolve over time. Always follow your surgeon's post operative care instructions when it comes to scar management to avoid any complications like infection and for faster healing and recovery.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Jeremy S. Nikfarjam, MD · Answer

Hi Easygoing,
I'm sorry to hear of the ongoing symptoms you're experiencing!Definitely bring this up with your surgeon. He/ she may have some potential solutions for you. 
You can consider taking a break from the Bio Oil and see if anything changes. The skin does appear a bit irritated. 
Best of luck to you!
- Dr. Nik

Connie Hiers, MD, FACS · Answer

You have some hypertrophic scarring which can be helped with steroid injections. Please go back to your surgeon.

Abnormal breast reduction scarring? (Photo)

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