Scar around the areola
As the others have mentioned, the quality of you scar is quite good. However you do have a marked discrepancy between sizes of your areola and it looks like you didn’t have to have a life on the right side or it has healed remarkably well.
Nevertheless, you can pursue a scar revision of your left side as long as you understand you could still end up with a similar result.
If this is extemely distressing to you, I think it would be worth a try as long as your breast skin around the areola isn’t exceptionally tight.
Tattooing could make it less noticeable but it won’t help with the size which to me is most noticeable.
Good luck with getting this more towards your liking. (Curtis Wong, MD, Manhattan Plastic Surgeon)
The scars that you developed as a result of your surgery is something that probably would not improve with sacr revision. Sometimes tattooing has helped. (Steven Wallach, MD, Beverly Hills Plastic Surgeon)
Periareolar scars
It looks as if you had a periareolar lift and if so this tends to cause a bit of areolar enlargement and spreading of the scar. However, you have very acceptable and normal scars. The only thing is the loss of pigmentation and this is unpredictable. This is fortunately the easiest problem with scars to improve.
Just apply a bit of makeup to break up the circumferential pattern of the scar. Raised, dark, discolored, thick, or widen scar are more problematic than hypopigmentation. DO NOT DO A SCAR REVISION, LASER, OR STEROID TREATMENT. And enjoy your otherwise nice result. (Robin T.W. Yuan, MD, Miami Plastic Surgeon)
As other experts state these appear as very acceptable scars and result. I would not recommend steroidal injections, or scar revision. You could try tattooing to skin colour. Otherwise you may be at an end point. (Darryl J. Blinski, MD, Chicago Plastic Surgeon)
Consider tattoo for car treatment
Your scars appear white so they are mature and I doubt a steroid injection or laser will help. A surgical revision (in the office) may be an option. One potential treatment that has not yet been mentioned is scar tattoo.
Some highly skilled tattoo specialists can have great results with these types of scars. Search out a specialist who does permanent makeup tattoos and go for a consultation. Make sure you see “before & after” pictures of their work. (Karol A. Gutowski, MD, FACS)
How can I improve the scars around my areola?
It is very difficult to evaluate your scars from the photos but they do not appear to be unacceptable. That being said, there are a number of ways to improve your scars including: injection of steroid scar taping application of scar improvement topicals (SkinMedica Essential Serum)
- Fractional laser resurfacing
- Direct scar revisionm (in-office)
Any of these procedures could potentially give you a little more natural appearnace to the scars and so you should really discuss these options with your surgeon. If he/she does not offer these then I would get a few other opinions. (Gregory A. Buford, MD, FACS, Denver Plastic Surgeon)
Improvement of raised areoalar scars
The areolas appear different in size so one solution may be to surgically revise the scars, make them more even and flatter.
Two years after the original surgery there will be less tension on the closure and the scar should heal better.
If you prefer not to have further surgery the scars can be flattened with steroids or laser resurfacing. Once they heal, the scars can be tattooed to better camouflage them. (Eric Sadeh, MD, Manhattan Plastic Surgeon)
Scar after breast augmentation
Patients scar differently after breast surgery. Not all patients heal the same way. Abnormal scaring can happened after any breast augmentation procedure. There are several types of abnormal scars. Hypertrophic scar is one that is red or dark purple and is raised; it usually improves some with time. They can be improved with steroid injection, silicone sheet and pressure. Keloid scar is one that is large red or dark purple but as oppose to hypertrophic scars, keloids do not confined to the incision. Keloids extend beyond the original borders of the scar.Keloids do not improve with time and are hard to treat. Treatment is usually steroid injection, pressure, excision and radiation. Keloids have a high incidence of recurrence after excision. In your case, you have a well mature scar over the periareolar area of your breast. It is not keloid and is not hypertrophic. Your areola is slightly large but not significantly large. You probably had an augmentation mastopexy via circumareolar approach (.Breast lift with implants with scars through the areola only). This picture is not very impressive as a bad scar. (Jaime Perez, MD, Tampa Plastic Surgeon)
From the photos that you showed, your areolas do not look too enlarged in proportion to your breasts. It is hard to appreciate the scar based on the photos as well.
If the areola scar is widened and raised, we can treat it with steroid. However, steroid injection may widen the scar further or depigment the area.
Another option is to perform circumareolar mastopexy to decrease the size of the areola and to remove the scar; However, you will then have a scar around the whole areola. (Sugene Kim, MD, FACS, Houston Plastic Surgeon)
Treatment for periareolar scars
A simple scar revision with areolar reduction under local anesthesia will improve size, shape, and the scar itself. (Daniel J. Casper, MD, Los Angeles Plastic Surgeon)
The photos are somewhat difficult to interpret since you are lying down.the best view would be a straight ahead (frontal) view while standing.
It is difficult to assess your contour, symmetry, areolar size and position in these photos.
It appears that you had a periareolar lift (“circular”, “concentric”, whatever one wishes to call it) at the time of your implant placement.
The scars do not look raised, red, “ropey,” so they do not appear from the photos to be what we call “hypertrophic” scars that would benefit from steroid injections, silicone gel sheeting, CO2 laser, etc.
The scars are fairly acceptable in terms of what you can expect from a periareolar lift.these are ALWAYS more noticeable than periareolar scars from augmentation alone. Perhaps you were not sufficiently warned about the scars, or perhaps you did not understand what you were told about the expected scarring.
Periareolar lifts are done to raise the nipples if they are too low and to reduce the overhang of the breasts if excessive, since augmentation alone in these cases will lead to a poor result.
Hopefully you understood why a lift was needed and agreed that the necessary improvement in contour was worth the trade off in terms of more conspicuous scars. The scars are a little wide, and there is some visible cross-hatching usually resulting from leaving external sutures in too long. It is possible that a scar revision could improve your scars and eliminate the cross-hatching, but you will go through the long process of waiting for the red scars to fade again, and although you may see some improvement, as with any scar revision there is no guarantee. You should discuss these options with your surgeon. (Robert M. Grenley, MD, Chevy Chase Plastic Surgeon)
You appear to have a circumferential periareolar scar, which is rarely used with breast augmentation alone unless the surgeon is performing a lift with the augmentation. Overall, the quality of the scar is what one can expect with a circumferential periareolar lift. I agree with the surgeon who previously suggested trying a tattoo. There are nipple tattoo professionals who will have the colors needed to mask the scar. You may find one by contacting a local plastic surgeon that does breast reconstruction as this technique is often used to re-create a areola after cancer reconstruction. (Marwan R. Khalifeh, MD, Redding Plastic Surgeon)
Putting large implants in a sagging breast and then attempting to lift the breast only by removal of the skin around the nipple complex is commonly doomed to fail. The subsequent sequence of events is always the same; the breast implants push the areola and the scar forward and massively stretch them resulting in large, ugly areolas and widened prominent scars, as is seen in your case.
Correction here can only be done by reducing the tension on the breast skin. This can only be done by exchanging your implant for a smaller one and reducing the areolas and surrounding scars. Attempting steroids, lasers and other voodoo will not correct the undrlying problem – the large breast implants acting as tissue expanders. (Peter A. Aldea, MD, Memphis Plastic Surgeon)
You have a normal results with scar depigmentation. If you’re really unhappy, tatooing might be the answer. (Blane T. Shatkin, MD, Fort Lauderdale Plastic Surgeon)
Areolar size can be reduced
Breast augmentation typically enlarges areolar diameter.
An option to consider is a peri-areolar donut mastopexy to reduce your areolar diameter.
The technique employs a GoreTex suture which ‘locks in’ the diameter of the areola.
I’ve done this a few times to revise patients like yourself. It works fairly well. (Scott C. Sattler, MD, FACS, Seattle Plastic Surgeon)
Most likely, the result of any scar revision will be the same. Tattoo is a good option in this case. (Shahin Javaheri, MD, San Francisco Plastic Surgeon)
Areolar reduction after breast augmentation
In most cases the areola will enlarge after breast augmentation. You only need to review a series of before and afters to see the change.
When augmentation is combined with an around the nipple breast lift as you appear to have had, the challenges on areolar size and scar spread are remarkable.
Our suggestion is revision of the scar with areolar reduction if the size is again an issue. Your skin is now relaxed 2 years after the augmentation and chances are you may do better. I don’t like the tattoo idea, revision is a better option. (Peter E. Johnson, MD, Chicago Plastic Surgeon)
Scars are inevitable after breast augmentation
5% of women develop widened scars following breast augmentation. Assuming your plastic surgeon closed the skin in 2 layers, using long-term dissolving stitches in the deep layer and fine or hidden stitches or glue in the skin, you may just be one of the unlucky ones who are genetically predisposed to poor scars. On the other hand, if you did not have your skin closed as I described, you could consider a scar revision by a board certified plastic surgeon. If your scars are red, you could consider a YAG laser treatment of the scars. (Arthur W. Perry, MD, Franklin Park Plastic Surgeon)
I am wondering why you have a scar around the entire areola. Did you have a lift as well? Are your breasts symmetrical? I would suggest that the scar can be revised, and a permanent “purse string” suture can be placed to keep the diameter the same. Get another opinion. (Scott E. Kasden, MD, Chicago Plastic Surgeon)
I do not see a prominent scar but if your are referring the the pigmentation, you could consider tattoo of the lighter colored portions of the scar. (Otto Joseph Placik, MD, Manhattan Plastic Surgeon)
I cannot see anything in the photo. Is the scar depressed? Is it widened? Is it within the areola?
Please resend question with close up photo of area of concern. In my experience, in many cases scars can be improved. (Tracy Pfeifer, MD, Orlando Plastic Surgeon)
I have to say that your situation is a big part of the reason I am not a big fan of peri-areolar techniques for breast lifting. The result is sometimes pleasing initially, but inevitably over time, the areolas stretch and the scars widen. The only long term effective solution to this problem once it has occurred is to remove the larger implants, place smaller ones, and surgically reduce the areolas and scars. I know this is probably not exactly what you would prefer to hear, but I don’t believe any other management will result in an outcome you will be happy with. (Armando Soto, MD, FACS, Englewood Plastic Surgeon)
Scar revision after Benelli Mastopexy
Repeat surgery is unlikely to solve the problem. If plan A doesn’t work redoing plan A is unlikely to help. If the scars are prominent perhaps judicious conservative injections of Kenalog may help. Some of the prominence may be due to a permanent stitch placed at the time of the initial procedure so check with your surgeon. If the problem is the pale color tattooing could be helpful. Maybe there is a tattoo artist in your area who works a lot with breast reconstruction patients. Ask a plastic surgeon who does breast reconstruction. The most dramatic option would be to add a vertical scar beneath the areola to take the tension and redo the scar around the areola. This is option most likely to offer longstanding improvement in your areola but adds more scarring. (Terrence Murphy, MD, Denver Plastic Surgeon)
The whiter scar at the edge of the areola is within the range of normal. It is unlikely that cutting out the scar will produce a better result. You might consider tattooing with careful attention to matching your skin tone to help camouflage the scar. (Paul C. Zwiebel, MD, )