Will they improve, or is it probable I’ll need scar revision? (photos)

Question

Hi! I had delayed healing due to spitting sutures after my breast lift earlier this year. I’m a bit concerned about the appearance of the scars. The verticals ones are wide and just a bit discolored at the top. The anchor one on the right side is very wide, red, and feels thin. Judging by this progress, what should I expect the scars to look like at maturity? Will they improve, or is it probable I’ll need scar revision? And is scar revision a bad idea if I had suture issues the first time? TIA!

Ronald J. Edelson, MD · Answer

Those scars are very good and will continue to improve. I would not bother with a revision at least not now. Let them get better on their own.

Stephen T. Greenberg, MD, FACS · Answer

Thank you for your question.  Scars do take about a year to a year and a half to go through their maturing phases.  In order to deal with the redness to a scar, I typically recommend doing some form of a IPL laser to help reduce the redness.  Use of scar creams are always a great option as well.  If you choose to re excise the incisions I typically recommend doing a small section at a time.  Reason being is that scars can heal worse, better or the same. I would recommend speaking with your surgeon in depth and following their recommendation.

Alan Gonzalez, MD, FACS · Answer

Hello @v.lynne, thank you for your question and showing you pictures. Scarring has a maturation cycle of approximately one to one and a half years depending on the patient's skin. Please note that in the photos the scar has different shades and the scar takes different features depending on the process inherent to the patient's health and skin condition. Best wishes! Alan Gonzalez MD, FACS.

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

Tommaso Addona, MD · Answer

Thank you for your question.
Scars can take up to a year to mature fully meaning that your scar may become flatter and thinner over time. I recommend using a silicone based scar treatment such as Biocorneum in order to aid this process. I would speak with your plastic surgeon about your concerns. They should be able to recommend a course of scar treatment.

Carmina Cardenas, MD · Answer

Most likely your scars will improve over the years. Time,  is the best friend of scars. 
Scar revision will have the same risk to end up with healing issues as was the primary surgery. 
You may still do a lot of things to improve the scars: cream, silicon sheets, massaging, laser. 
Be encouraged. 
Dr. Cárdenas

Daniel Barrett, MD · Answer

Dear v.lynne,
I understand you are concerned with the appearance of your scars. As your scars heal, it should flatten out and lighten. Loss of pigmentation or hyperpigmentation may also be experienced but will resolve over time. Always follow your surgeon's post operative care instructions when it comes to scar management to avoid any complications like infection and for faster healing and recovery.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Camille Cash, MD · Answer

It's best to wait about a year after surgery before considering scar revision.  Scars will continue to heal and fade over time.  The tension on the scars will be different now than it was at the time of surgery, which should lead to a better scar outcome if you elect revision.  The use of scar products afterword such as silicone strips may also help with favorable scar healing.

Connie Hiers, MD, FACS · Answer

For now, micro-needling could be very helpful. Once you reach 6 months from surgery, then you could consider a revision for more narrow scars.

Jeffrey C. Hamm, MD - Account Suspended · Answer

Hi and welcome to our forum!
From your photos, postoperative immature surgical scarring of a full pattern lift is noted. It appears to be healing satisfactorily with the exception of a broadened area of the transverse limb of the left mastopexy scar at the junction of the three flaps where there was apparent delayed healing.. 
Scar healing is a dynamic process which takes 12-18 months to complete. During the interim, the scars may be red (from underlying hypervascularity) and thickened (due to inflammation). One must be patient until the process is completed. The thinned out portion at the site of delayed healing will most likely remain thinned out. It will, however, fade with time. Only you can determine if the scar requires a touch-up after healing is complete.
As there are many different types of suture material and suturing technique, a different method of closure may be employed.
Continue follow-up care with your plastic surgeon.
Best wishes...

Will they improve, or is it probable I’ll need scar revision? (photos)

Answers (10)

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