My areolas are uneven with raised scars. What happened? What can be done about this?

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

Hello @Genuine928597, thank you for your question. The scarring in a 99 per cent is associated to the genetics of the patients and to the movements and daily activities of the patients, that is why there are recommendations to ensure the best healing possible. There are many things nowadays to be able to manage a scar process. Technologies like laser, fixer and other products to make the scar smaller or minimize it those are nonsurgical treatments or you could consider a scar revision. Your surgical o non surgical plan will depend on what you want to achieve. It is important that you have a consultation with a board certified specialist to determine a surgical plan according to your needs. Best wishes! Alan Gonzalez MD, FACS.

It is not that infrequent to see some asymmetry in size of areola and entire breast after breast surgery. In most cases some asymmetry was present before surgery, but if it is not recognized and discussed with patient, it may create additional confusion after surgery. In any case, if serious, this can be corrected, both areola and breast volume adjustment. Breast as well as any other scars, take good 12-18 months to settle and mature; management with occlusive scar tapes and gels is something that may help even now. Open communication with your surgeon is best way to correct current issues. Good luck.

Dear Genuine928597,
I understand your concern. However, without a proper assessment, it would be difficult to determine what went wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

If you discussed you concerns with your surgeon, and he chooses not to revise your scars, you might want to visit with another surgeon. Surgical assistants are used very commonly in surgery, especially with long procedures, and they are quite legal.

Hi and welcome to our forum!
Unfortunately, a verbal description doesn't provide us with enough information to decide upon a revisional procedure.
You report postoperative breast asymmetry, residual sagging, areolar asymmetry, and thick scarring.
The asymmetries can be revised. The scarring, however, may or may not be problematic.
We must differentiate the difference between hypertrophic scars and keloids.
A hypertrophic scar represents an abnormal response to tissue injury, resulting in deposition of excess collagen. Its prevalence is increased after infection or in wounds under mechanical stress. The scar doesn't grow beyond the boundaries of the original skin injury.
A keloid is a genetic inherited disease in which scars progressively thicken beyond the boundaries of the original skin injury.
There are non-invasive and invasive methods to treat these entities. Hypertrophic scars often spontaneously regress with time, the final scar noted when the redness of inflammation has subsided (usually at 12-18 months). Keloids may become inactive but usually do not regress.
The application of pressure and immobilization of a scar with silicone gel sheeting appears to hasten resolution of the process. Various creams are available, but their efficacy is questionable.
Laser treatments are available with varying degrees of success.
Injection of corticosteroids directly into the scar may flatten the scar and alleviate symptoms, but may also broaden the scar and cause pigmentary change in the skin locally. For this reason, we usually delay its use for as long as possible.
Surgical scar revision is an option to consider if regression is not noted at 12 months after the procedure. This is often successful in treating hypertrophic scars, but, on the other hand, keloid recurrence is quite common.
I recommend you set up another appointment with your surgeon specifically to discuss your options. Make sure he/ she understands your concerns. If your doctor refuses to discuss options of treatment, it may be time to seek a second opinion.
Best wishes...