I have indentations, spider veins and hyperpigmentation after my augmentation. What can be done for this? (Photo)

Question

I had some steroid injections in my breast implant scars and now there are indentions on one side, spider veins, and hyperpigmentation. Its been about 3 months since the injections and my augmentation was January 3rd. I've read that it's from the steroid injections. Is there anything that can be done for this? I am feeling really discouraged.

Daniel Barrett, MD · Answer

Dear Kayleekd3012,
I understand your concern. However, without a proper assessment, it would be difficult to determine what went wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Raffy Karamanoukian, MD, FACS · Answer

Fractional laser is an amazing and highly effective treatment in our office. We use the laser treatment to help with acne scars, large pores, fine wrinkles, tissue collagen loss, scars, sebaceous hyperplasia, active acne, and for brightening dark pigmentation. Although there are very strong fractional lasers such as CO2 laser, we use lighter treatments for corrective skincare and maintenance of results. Our Thulium fractional laser, clear and brilliant laser, and Ultra Thulium laser are excellent options in our clinic. We also perform CO2 fractional and erbium depending on skin tone and tolerance for downtime. Patients do have to use a Melarase cream before and after treatment to help further reduce pigmentation after laser.  Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. Dark spots can improve with these treatments. I recommend fractional laser for incisional scars as well, especially after plastic surgery.  
Best,
Dr. Karamanoukian 
Realself100 Surgeon

Derek Fletcher, MD · Answer

Based on your photos, I would recommend a scar revision, which can be performed under local anesthesia.

Dinah Wan, MD · Answer

Scars typically continue to fade up until 1 year after surgery, so do not lose hope! You can try silicone gel or silicone sheeting over the scar in the meantime. Also make sure you apply SPF over the scar when you are in the sun.

Zoran Potparic, MD · Answer

Most likely that this result is temporary and that scar maturation, which is in progress, will end up with better looking scar. Laser treatment may be considered and taping with scar tape for long period of time. Hope this helps.

Gianfranco Frojo, MD · Answer

There are many options for this. The most simple is to perform silicone scar taping over the scar for the first 3 months. In addition, there can be steroid/5FU injection, broad band light therapy, fractionated laser therapy, and many other options. The most important thing is to control tension on the scar with the silicone scar tape.

Heather Vande Ven, DO · Answer

Some general suggestions for post-augmentation concerns. 
1. Indentations: Depending on the type of augmentation, indentations might require surgical revision or fillers to correct.2. Spider Veins: Sclerotherapy or laser therapy are common treatments for spider veins.3. Hyperpigmentation: Topical treatments like hydroquinone, chemical peels, or laser therapy can be options to address hyperpigmentation.
Consult with a board-certified plastic surgeon to discuss your specific concerns and available treatment options. They can provide you with a tailored plan based on your individual needs and goals.

Bruce K. Smith, MD · Answer

There is always something that can be done to improve scars and sometimes the best treatment is time and patience. All scars go through stages or phases of healing and the first stage is the "inflammatory" stage where scars are thick, pink and slightly raised. The last stage of wound healing is the "remodeling" stage where scars flatten and fade. If you want to try to fade the hyperpigmentation and take away some of the redness of the early inflammatory stage; a series of IPL (Intense Pulsed Light) may be of some benefit in combination with bleaching cream. This is exactly the reason that I like a transaxillary ( incision hidden under the arm) approach, if possible. If there is a thick or ropy scar, it is hidden.

Camille Cash, MD · Answer

It takes about a year for scars to mature.  You can consider laser treatments and silicone sheeting to help to improve the appearance.  If after a year you still have concerns you can consider scar revision which would remove the current scar tissue.

Douglas Taranow, DO, FACOS · Answer

Kaylee,
I would seek out a physician with several Laser machines.  Several lasers treat red scars very well.  It usually requires several treatments and is not covered by insurance.
Best wishes,
Dr. Taranow

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