What Are the Chances of Unfavorable/noticeable Scarring in Breast Augmentation?

Does it have to do with the patient's genetics or doctor's skills or both? How can this be prevented? How do you guarantee that the scar will be a thin, white, barely noticeable white line. Thanks!

Doctor Answers 14

What are the chances of unfavorable/noticeable scarring with breast augmentation?

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Hello! Thank you for the question!  Breast incisions typically heal very well and well-hidden when placed properly.  It is common for scars to fully mature for up to a year. In the meantime, there are a few things that may help to ameliorate your incision/scar. The most proven (as well as cheapest) modality is simple scar massage. Applying pressure and massaging the well-healed scar has been shown to improve the appearance as it breaks up the scar tissue, hopefully producing the finest scar as possible. Other things that have been shown to add some benefit, albeit controversial, are silicone sheets, hydration, and topical steroids. These can usually be started at approximately 3-4 weeks postop and when incisions healed. In addition, avoidance of direct sunlight to the incision will significantly help the appearance as they tend to discolor with UV light during the healing process. Scars will never disappear, but attempt is made to make the finest scar in a concealed location.

If unsightly scars are still present after approximately a year's time, other things that your surgeon may consider are intralesional steroid injections, laser, or just surgical revision of the scar itself.

Hope that this helps! Best wishes!

Scottsdale Plastic Surgeon
5.0 out of 5 stars 28 reviews

Breast augmentation scars very rarely a cause of dissatisfaction.

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1) It is very, very rare for a breast augmentation patient to be unhappy because of the scar.  Different from a breast lift, for example, where the scar is noticeable and there is a trade off involved.

2)  Technical points: A)  Keep the scar very short.  B)  Make it inconspicuous (usually in the fold or at the border of the nipple, sometimes in the armpit).  C)  Do not bruise the edges of the wound during surgery.  D)  Close the wound in three layers.  E)  Keep the scar taped for a month.  F)  Apply BioCorneum scar gel twice a day after that.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon

Scars after breast augmentaton

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Scars are influenced by many factors.  Some include genetics, your skin tone, surgeon technique, and tension on a scar.  There is no perfect solution to guarantee that your scar will turn out perfectly in your eyes.  The best idea to help you is to talk with your surgeon about your concerns to get advice based on your situation.  After surgery you can try fade creams or silicone sheeting to help as well.  Good luck!

Mennen T. Gallas, MD
Katy Plastic Surgeon

Scars after breast implants

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Meticulous technique, small stitch size, and good scar therapy after a breast augmentation are things that I do with my breast augmentation patients to help get the most inconspicuous scar possible.

Breast augmentation scars

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I think that most unfavorable scarring related to breast augmenetation is genetics.  Sure, if a wound has secondary healing because of infection or what not, it probably will not heal well. Sometimes stretching of the tissue can lead to unfavorable scarring,and then a scar revision can be helpful. If the scar is too light over time especially when using a periareola incision, local tattooing may help.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

There are no guarantees in life

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We do our best. The quality of the scar is up to  your body. I like the circumareolar scar, it is usually the best, but if you form keloids, or hypertrophic scars, it wont look so good.

William B. Rosenblatt, MD
New York Plastic Surgeon
4.2 out of 5 stars 12 reviews

Breast Aug scars?

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Breast Implants can be placed through 5 different approaches: arm-pit, nipple, crease under the breast, belly button or groin (with a tummy tuck). The scars are only 1 inch in length with saline implants and they virtually disappear in 99% of patients. Those occassional exceptions to the rule require addittional treatments but always can be eventually resolved. Experienced plastic surgeons do have more skill with the variations in skin types but the size & shape of the resulting breast is the single most important thing. Don't hinder your surgeon by insisting on something other than what he or she reccomends. Every surgeon knows what works best in his or her hands. Go with the reccomendation to get the best result.

Dr Foster     Lake Tahoe Plastic Surgery

Lawrence Foster, MD (retired)
Sacramento Plastic Surgeon

Breast augmentation and scars

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Unfortunately, scars are inevitable in plastic surgery. These are the factors that assure good healing the majority of patients:

- meticulous layered closure
- placement of scars in inconscpicious locations
- decreasing tension on the scar
- proper post surgical scar program and adherence to it
- patients inherent anbility to heal

The breast enhancement procedures that offer the least amount of scarring are:

- TUBA or Trans Umbilical Breast Augmentation where Implants are placed through a scar on the inside of the belly button or
- AFT or fat transfer to the breasts where your own fat is used for augmentation with tiny introduction scars.

Please have a consultation with a ABPS certified plastic surgeon to evaluate your candidacy.

Kevin Tehrani, MD, FACS
New York Plastic Surgeon
4.7 out of 5 stars 112 reviews

"Thin, white, barely noticeable" scar is quite possible!

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Unfortunately, you are right about a patient's genetics also being a factor. Fortunately, only  about 5% of patients have excessive scar production genes (hypertrophic or keloidal scar tendency). The other 95% or so have the potential for a great scar, but only IF the surgeon does a technically precise and exact closure with the proper suture materials!

Most plastic surgeons have had complete training in General Surgery, ENT Surgery, Orthopedic Surgery, or Urology (all acceptable pathways to enter plastic surgical training) by the time they start their plastic surgery fellowships. Some of these eventual plastic surgeons never believed it important to improve their suture choices or surgical closure techniques, but the vast majority learned that more delicate tissue handling, finer sutures, more precise skin-skin closure in layers designed to relieve tension on the surface, and better wound care resulted in better scars for their patients.

Some feel that "God heals them one way or another" and that speed is more critical (time is money) than taking a few minutes more to do a superior job!

So, even if you are blessed with genetics that are not only in the majority, but capable of truly minimal scar formation, it still depends on the attitude AND actual performance of the surgical closure by the plastic surgeon of your choice. Look at lots of photos; understand that full scar maturation takes an average of 7 months (6-12 is normal for most), and listen as your surgeon describes what he or she thinks is important about your proposed surgical procedure. If it sounds like "just another day" in the OR rather than the most important thing s/he is doing for you, then perhaps you need to have a few more consultations with other ABPS-certified plastic surgeons, and find one who takes pride in his or her attention to detail! Best wishes! Dr. Tholen

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
4.9 out of 5 stars 263 reviews

Favorable scars with breast augmentation

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Every patient scars slightly differently and there is certainly a genetic factor to good and bad scarring. But some scarring can be improved with surgical technique and post operative care. There are never guarantees when it comes to scarring, but that does not mean that every attempt to optimize your chances of a good scar should not be made. Bad scars are often a result of tension. Surgical techniques can definitely reduce tension as can post operative dressings (i.e. steri strips). And even more importantly, the pre-operative planning of the location of the scar is crucial. If the breast crease incision is to be used, the incision should be placed a certain distance below the existing breast crease that varies slightly with the size of the implant and the rest of the breast anatomy. Even a poorly healed scar that is well located in the breast crease is not as bothersome as a good scar that is visible on the bottom portion of the breast. 

Wm. Todd Stoeckel, MD
Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 87 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.