Vitamin E Vs. Mederma For Breast Reduction Scars? (photo)

I have been told by others via internet that i should use mederma for my breast reduction scars, (had it done on the 31st of May w/ lipo on my sides) but my doc says Vitamin E twice a day. Yesterday i read an article that Vitamin E can make it worse and that its just not as good as other scar healing products. can you please advise me on this matter? what would you recommend? Thank you for your time :)

Doctor Answers 9

Vitamine E Vs Mederma for post op scars

This is a very common question and usually it is your surgeon who will recommend the best scar treatment for you. I recommend scarguard for my patients. It has Vit E, steroid an silicone. It is applied once daily. good luck


San Diego Plastic Surgeon
5.0 out of 5 stars 15 reviews

Best Breast Scar Management

I don't think that either Vitamin E or Maderma is the best option for the best breast scar maturation. Best Scar Management is important to minimize or completely hide from view, the telltale signs of your surgery—namely, scars. Both you and your surgeon want you to have the most minimal scarring possible. There are many possible causes for scars that are enlarged or not healing well. Unsightly scars are most commonly due to genetics, underlying medical conditions, or improper scar/wound care. The last part is very important and patients can make a noticeable difference in their scars’ appearance by following best scar management practices. Here are some simple tips.
Scar Management tips:
  1. Minimize tension on the scar. Steri-Strips and/or surgical tape are often placed in non-hair bearing areas at the time of surgery to minimize tension and keep pressure over the scar. This minimizes the stress that can pull the scar apart (dehiscence) creating a wound and delaying healing time, and can make the scar wider, or more “ropy”. In the first few weeks after surgery, I recommend the use of Embrace Scar Therapy which is an adherent silicone sheeting pre-stretched when applied so as to offload tension on the scar.
  2. Keep your incision site/scar clean to prevent infection. Follow your surgeon’s wound care instructions to the letter with out modification. Never apply different products then recommended without first discussing them with your surgeon. This is especially important during the first few weeks. If there are any signs of infection, contact your surgeon’s office right away and/or see your doctor or his nurse immediately. Typical signs of infection may include redness outside the immediate incision site, asymmetric swelling, and drainage, of pus, fever, chills, and “feeling sick”.
  3. Protect your scars from the sun. Staying out of the sun is the best advice. Minimal exposure to sunlight is prevents hyperpigmentation (permanently turning brown) and other problems that can make the scar more noticeable. Sunscreen, at least 30 SPF and an overlying make camouflage make up additionally protects the scar from the suns harmful rays. This advice is especially important the first year following your surgery.
  4. Use specific scar maturation products recommended by your surgeon. Patients seem to have their own opinions on this touting everything from Pure Vit E, Coco butter, to Aloe Vera, etc but most have minimal benefit other than keeping the scar hydrated. Although hydration is important there are better, scientifically studied products with greater efficacy. Most of the scientific articles written about this subject indicate that topical silicone gel or silicone sheets work the best. The best product available in my opinion is the Embrace Scar Therapy System by Neodyne BioSciences, Inc. available in many surgeons’ offices. Essentially this is an adherent silicone sheeting pre-stretched when applied so as to offload tension on the scar. For areas that are not applicable for this product (e.g. smaller areas or on the face), I prefer BioCorneum or Kelo-Cote products There are a lot of products to choose from, but silicone should be one of the key ingredients. Although Mederma, an onion extract derivative active ingredient rather than mainly silicone based may help, primarily silicone based products are better and many also contain other ingredients that may be synergistic (hydrocortisone or other steroid, Vitamin E, Sunscreen, etc).. If the reader has problems obtaining these they can call my office. Patient compliance is also critical – use often and according to directions or it will not work optimally. NEVER apply products without first discussing them with your surgeon.
  5. Monitor to make sure your scar is progressing optimally. Keep your scheduled follow-up appointments with your surgeon to verify that your scars are maturing as expected. Occasionally if indicated you may need a topical steroid preparation or even a series of injections (5-FU and/or Steroids) or laser treatments to treat or prevent scar hypertrophy or keloid formation (red raised scars), or other topical medicines to treat post inflammatory hyperpigmentation (brown scars) with prescription creams and possible laser treatments.        #optimizingbreastscar    #scartreatment #scarmanagement

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 108 reviews

Breast scar management

Thank you for your question. Breast incisions can be managed using a multimodal approach:
1) Scar massage - starting as soon as the surgical dressings come off and the incisions are sealed
2) Silicone sheets or scar gels for about six months to year
3) Embrace - a tension reducing dressing for the first 2 months
4) Fractionated lasers to help blend the scar into the background - done as a series, starting about 4 weeks after surgery and repeated every four weeks for six months.
5) Sunscreen to prevent the scars from darkening

Mederma vs. vit E for scars

Unfortunately, we cannot perform surgery without creating scars, and patients always want to know how to minimize their scars as much as possible.  There are many products available -- many of them very expensive.  I usually recommend that my patients massage their scars using any moisturizer or cream of their choice (Vit E, aloe, etc). To my understanding, the literature hasn't really said whether one cream is better than the other, but rather the actual act of massaging is important.  If the scars are hypertrophic then steroid injections or silicone sheets may also be of benefit.  I would definitely discuss this issue with your surgeon because he or she may have his/her own preferences.  Good luck!

Anureet K. Bajaj, MD
Oklahoma City Plastic Surgeon
5.0 out of 5 stars 17 reviews

Getting the Best Possible Scar After Breast Reduction

The obvious answer to this question is you entrusted your body to your plastic surgeon and he or she did an obviously great job (as demonstrated by your above picture).  Every plastic surgeon has an opinion on wound healing and how to get the best possible scar.  Having said that, I will be happy to throw my opinion into the mix.  I think Mederma is a waste of money and time, and there is no proof that it actually has any lasting effect on the quality of the resultant scar.  I am very opposed to Vitamin E because, chemically, Vitamin E breaks the SH bonds.  These are the bonds which hold collagen fibers together, therefore, if you put enough Vitamin E on a well done surgical scar, it will break the bonds and make the scar wider.  Vitamin E is good for thick, heaped up scars because it will flatten them, but unfortunately, for flat, excellent surgical scars, it will spread them. 

 

I believe in tape.  Tape causes pressure.  Pressure tells the new collagen fibers how to come in smoothly and not in whirls and swirls, therefore the scar won't be heaped up.  This helps the scar mature faster, and mature scars lose their redness and look better.  My favorite tape for tummy tucks and breast reductions is Proxy strips.  The tape normally stays on for two weeks at a time, and to get the best conceivable result, may take several months of taping.  The mastic keeps the scar from spreading and the pressure keeps the collagen flat, and the combination of these two lead to a quicker maturation of the scar.  In short, they work. 

Incision care

First, Vitamin E does not improve scar quality. Any moisturizer once things have healed are good. Mederma has not been shown to help scars significantly. The best thing if a scar is problematic is using a silicone sheet.

Steven Wallach, MD
New York Plastic Surgeon
4.0 out of 5 stars 23 reviews

Postop scar treatment

Who should you trust more, your plastic surgeon (who, hopefully, is board certified and completed a 7 year residency followed by 2 very difficult, comprehensive examinations) or an article you read somewhere? You should follow your surgeon's recommendations. I think it is fundamentally important that, having selected a physician to perform your procedure, you comply with his followup regimen. I, too, recommend Scarguard but believe that the recommendations should come from the individual most knowledgeable about your care. You should not self-treat based on what you read on-line or elsewhere.

Best Treatment for Breast Reduction Scars?

Thank you for the question and pictures. I would suggest that you run this question by your plastic surgeon who is ultimately responsible for your care. He/she will be a better resource than the online research that you are doing.  Ask him/her if he/she recommends the use of silicone-based products.

Best wishes.

Scars

Hello,

 

There is many products that can help you with your scars, you can use over the counter or Physician grade. Mederma is a well known products a lot of patients use it, i would do research on either product so your able to make a informed decision.

Stuart B. Kincaid, MD, FACS (in memoriam)
Beverly Hills Plastic Surgeon
3.5 out of 5 stars 9 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.