Original surgery almost 30 years ago, 3 revisions since. My implants are still too high, want to go smaller and hope for a more natural appearance for my age, but REALLY want to treat the "indentation" deformity caused by my scars. Last dr. said "tight" or "contracted scar" and did not offer any solution. Do you think this problem can be corrected?
Can the Scar Deformity from my Breast Augmentation/revisions Be Corrected? (photo)
Doctor Answers 3
Can the Scar Deformity from my Breast Augmentation/revisions Be Corrected?
Thanks for the posted photos. In my opinion why not just treat the indentation on the left inferiolateral breast? I would try dermal 16 gauge puncture release with superficial fat grafting to elevate the indention.
Fixing Indented scars
Sorry to hear about your scars. It's a tough question to answer without seeing you in person, but most of the time , these can be fixed. It appears that the surgeon might not have reapproximated the fatty layers together during the closure so you may be missing tissue in that area. Sometimes, a simple fat graft may fix it; sometimes we need to rearrange some deep tissues to fill in the indentations. Other times, we need to revise the scar tissue capsule to get it to look right. Finally, there are times when scars that have contracted and become too short need a "Z-Plasty" to fix them. Hope this helps.
Can the Scar Deformity Be Corrected?
Except for the fact that your scars are right at the site of the indentation, I would think that this is "double bubble" and that we are looking at the lower edge of the pectoralis muscle (assuming the implants are submuscular).
Since they are right at the scar, this may represent a simple scar contracture. An examing surgeon should be able to distinguish between these two possibilities.
If this is a double bubble, switching out to a smaller implant and adding Strattice, a biologic tissue substitute, to reinforce the pocket would the best choice.
If it is scar contracture, "Z-plasties", a technique to re-orient the scar and add tissue to the tight areas is in order. In light of the multiple revisions you have already had, adding some Strattice under the skin repair may well increase the chances of a good result.