A breast augmentation is usually not associated with poor scarring, as the scars are generally well hidden and inconspicuous no matter where the incision was placed. A breast lift is associated with longer incisions, so with that procedure there is a possibility of more visible scarring.
A patient’s genetic makeup determines about 80 percent of the final appearance of a scar, and a scar will take up to two years to fully mature and look its best. Some patients simply heal better or worse than others.
Poor scarring generally results from a genetic propensity to make bad scars, inexpert surgical planning, or post-operative healing problems. The rating of scars as good or bad is quite subjective. Some patients have excellent scars that they complain about, while others have poor scars that they have no problem with.
A special mention should be made about breast lifts performed only around the areola (also known as a Benelli lift). It sounds wonderful, but the fact is the technique is fraught with scarring problems, and the actual “lift” is usually minimal at best. The scar can spread and look unattractive. It is “sold” to patients who fear breast lift scars and believe this is the smallest-scar lift procedure offered.
Scar revision refers to the manipulation of a scar in order to improve its appearance. Various techniques can improve the location and appearance of a scar by better situating and camouflaging it with the contours of the breast. A complete revision of a breast lift often reshapes the breasts and makes for better scars.
What should I do if I think I have poor scarring after my breast surgery and my surgeon tells me it’s normal?
I would suggest visiting another surgeon for his or her opinion. Usually, it is the unsatisfactory result of previous surgery and not the actual scar that is the problem. Perhaps the breast was lifted, but the lift wasn’t quite what you thought it would be. A breast enhancement that involves breast lifting or reduction and implants is a complex undertaking potentially associated with poor results, particularly in the hands of inexpert surgeons. Few surgeons want to admit to unsatisfactory results.
Do lasers help scars after a breast enhancement?
Lasers are not the “holy grail” of scar management. The benefits of using a laser to improve the appearance of a scar are minimal at best. Quite frankly, it’s a waste of time and money.
What is a poor scar? What is normal and what isn’t?
I rarely encounter raised scars after breast surgery. If I do, the scar is most likely a result of a patient’s genetic predisposition to poor scarring or the result of delayed healing after surgery. Patients usually complain of scars that are a different color or wider than usual (more noticeable).
What are some of the more common treatments for poor scarring on the breast?
A scar revision is a procedure that surgically changes the scar. Laser, dermabrasion, and other non-invasive treatments exist. The use of silicone scar strips helps tremendously in younger scars (less than six months). Massage helps thicker scars and should be performed daily for at least an hour. Steroid injection in raised scars helps tremendously, but it needs to be injected infrequently and expertly or depression can result. Compression helps all scars.
What can I do to make sure I obtain the best scar from my breast enhancement?
First and foremost, seek the services of an expert plastic surgeon. Wear a supportive bra 24/7. Use silicone scar strips all day for several months. Wait two years for the scar to fully mature and look its best.
Do breast scars make my breasts appear less attractive?
I think we can all agree that having no breast scars is desirable. However, having poorly shaped, unattractive breasts is like having a scar. I can assure you that attractive breasts with inconspicuous scars are a far better alternative. Men are not detail oriented when it comes to breasts. They see the big picture and not the scars. An attractive breast with scars is just fine.
Are there any creams or ointments that improve scars?
Topical application of any cream or ointment is unlikely to improve scars. Silicone gel is simply not the same as silicone strips or tapes when it comes to improving scars.
If you were to recommend one treatment to make the best scar, what would it be?
That’s simple—the use of silicone scar strips ten hours a day for four months.