Areola scars and residual areola post breast lift (Photo)

Question

I am 13 months PO from a breast lift (anchor). I feel I've been very patient about allowing scars to heal. I have two questions regarding scarring. #1 My areola scars are so raised and ropey. What should I be doing? Any chance this will improve? If not, what next? #2 I have lots of residual areola. What's involved in ridding my breasts of it? Will it cause additional scarring?

Carlos Mata, MD, MBA, FACS · Answer

Hi Desert Rose,

Thanks for your question and photos. It certainly is correctable with no addition scars. It just means redoing your scars with surgery. In order to minimize the chances that your scar will widen or become hypertrophic or elevated , you will need to make sure that you have no tension or pressure on your scar after the surgery and would recommend you use silicone strips that remove the stress on your incision. These can be expensive 200-600 dollars for a 6-8 week supply. Discuss your concerns with your plastic surgeon. Good luck!

All the best,

Carlos Mata MD, MBA, FACS

@blepharoplasty @facelift

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Board Certified Plastic Surgeon

Raffy Karamanoukian, MD, FACS · Answer

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

Gerald Minniti, MD, FACS · Answer

Hello,You look to be ready for a revision breast lift. It would involve revising all incisions; periareolar, vertical, and inframammary. This will allow complete removal of residual areolar pigmentation around the vertical incision and reduce the periareolar scars. If your surgeon is not a ABPS certified/ASAPS member surgeon expert in all forms of cosmetic breast surgery, including revisions, you should visit a few for a second opinion.Best of luck!

Tania Medina de Garcia, MD · Answer

Hello dear, thanks for your question and provided information as well..

The breasts may lose their elasticity and firmness which can be caused by different factors such as pregnancy, massive weight loss, lactation and aging. To reaffirm the breasts and restore the natural look your surgeon can perform a mastopexy or breast lift. A breast lift restores a firmer, perkier, and more aesthetically pleasing shape to sagging breasts. This not only can improve a patient’s appearance by restoring her youthful, feminine proportions, but  also help bras and swimsuits fit more comfortably and attractively. By removing excess, stretched out skin, reshaping the breast tissue, and raising the nipple & areola into a more forward position, a cosmetic surgeon can create a more youthful breast contour. Stretched, large areolae can also be reduced during breast lift surgery, creating an overall better proportioned, natural looking breast, Actually the perkiness on a person or another, depends on patients skin and breast tissue!

Jeffrey Nelson, MD · Answer

Your question is a good one and a dilemma when ever scaring proves worse then we expected or hoped. Anyone with darker skin is more prone to scaring problems, both thicker scars or potentially darker scars. If you have other areas on your body that had surgeries or injuries and they scared that way also it means you might do it again it revised. Still now that your far enough out from your surgery you might have your surgeon revise your scars, but first pretreat your skin with Hydroquinone a topical agent that can decrease recurrent darkening and then also when recovering be more aggressive with topical scar ointments, topical silicone, or topical steroids earlier in your recovery assuming that wasn't already done. Now that the skin has relaxed and time has pasted a revision might not result in the same scaring problems, or at least may be much milder. Good luck going forward.

Curtis Wong, MD · Answer

and at this point, you could consider a scar excision revision but there are no guarantees it will be better, though it probably will.  Additional excision of tissue can rid  yourself of the retained areola in her vertical scar.  You could consider steroid injections with your next procedure or intervene early if poor scarring appreciate and use every reliable scar product out there to help keep the scars minimal.

Areola scars and residual areola post breast lift (Photo)

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