What causes scars to widen after surgery? Going for a revision surgery.

Question

What are the reasons scars stretch or widen after surgery (specifically breast lift) 1. Surgical technique? 2. Pressure/tension from the lift? 3. Improper scar maintenance? Those are the most common answers I've seen but what causes the widening and how do I avoid it from happening again during a second revision surgery?

Gerald Minniti, MD, FACS · Answer

That's why it's important for surgeons to use sutures that tighten deep fascia to support wound closure, use carefully placed finishing sutures, and tape using elastic and porous tape for months after surgery. Tension reduction, precise epidermal closure leading to rapid epithelialization, and mechanical support of the suture line all play a part in fine scaring.

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

Camille Cash, MD · Answer

All of the things you mentioned can influence how your scars heal after surgery.  You want to be sure first that you select a board certified plastic surgeon for your procedure.  You want to ensure that the proper lift is done.  Some patients try to "get by" with a more minimal lift to avoid scars, but end up with poorly healed scars because the lift performed was not adequate for the patient.  After your procedure closely follow your surgeon's instructions.  Begin scar therapy as soon as it's deemed safe to do so and make sure you are consistent with it.

Gary M. Horndeski, MD · Answer

If you have a vertical scar technique for your breast lift then the mechanical load on the vertical scar is widening.  For that reason, there are two techniques that avoid the vertical scar: The Bellesoma Method or the mini lift.  However, if you already have these scars present then there is not much you can do about it.

Best Wishes,

Gary Horndeski, M.D.

Mark Baldwin, MBBS · Answer

The answer is of course "all of the above"...but the biggest factor, that you haven't mentioned, is genetics. In general the patients needing a breast lift don't have great skin elasticity, and are prone to getting stretch marks and developing widened scars. The 2 biggest 'red flags' for scar stretch in my experience, are previous scars stretching, and natural stretch marks. If it's your second revision, (as opposed to first revision) then I doubt you can full prevent it.

What causes scars to widen after surgery? Going for a revision surgery.

Answers (10)

Answer: Scarring

Answer: Scarring

Answer: Scar stretch

Answer: Scar stretch

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Everything you need to know about Breast Lift

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What causes scars to widen after surgery? Going for a revision surgery.

Answers (10)

Answer: Scarring

Answer: Scarring

Answer: Scar stretch

Answer: Scar stretch

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Recommended reading

Everything you need to know about Breast Lift

Our mission is to create a world where every investment in modern beauty is Worth It.