Ask Dr. Pane: Will a second breast reduction help with removing scars?

Dr. Pane evaluates the case of a patient who would like to remove her scars from a previous breast reduction procedure.

The Question

In many cases, it’s hard to say for certain how a given procedure is going to work out until the healing process is complete. This could take several months to a year or more. Think about your body and how it has changed in the last year. What about the last five years, or ten? Because of these changes, it is not unusual for patients to consider revision procedures to help adapt to significant alterations in their bodies or amend unwanted side effects. An example of this is the focus of this week’s Ask Dr. Pane segment. The patient had a breast reduction procedure from a D cup to a C cup several years ago, and wants to know if a follow-up procedure can help remove the scars.

The Case

The patient included pictures, as well as a brief precis of her surgical history. Because she was considered to not be a candidate for the “lollipop” scar, she was left with an inverted-T anchor-style scar. Dr. Pane’s evaluation is based on this information.

The Answer

Scarring is a natural part of the healing process, and occurs both inside and outside the body. While cosmetic surgeons make every effort to minimize scarring, there is no practical way to completely eliminate it without actually removing the skin bearing the scarring. This means that although the scar under consideration can theoretically be removed, it ultimately just moves the scar from one place to another and is generally not considered to be worth the discomfort and risk. Proper wound aftercare can help reduce their appearance, but there is simply no way to prevent some scarring after surgery.

With this in mind, in this case the patient can likely expect a good outcome from having a second breast reduction performed. Dr. Pane said the best approach would probably be to redo the reduction and add an implant, which would help shape and add volume to the area. While this is being done, the scars, which look good in this patient’s case, could be remediated to a degree through surgical means.

One point Dr. Pane was careful to mention is that while remediating scars in the horizontal dimension (across the area of the nipple) is sometimes possible, it is generally NOT possible in the vertical dimension (along the slope of the breast from the nipple toward the body). A great deal here depends on where the scar is located, its orientation to the primary breast tissue, its depth or elevation, overall width and whether it was placed correctly initially. The primary advantage of an implant here is to correct the sagging bust line the patient reports, as well as to stretch out the skin and so make the scar less noticeable in the areas where remediation or removal is not a desirable option.

Patients who are considering surgical intervention to revise scarring should be aware of the issue of horizontal versus vertical scars. Dr. Pane cautions that vertical scar remediation is often not possible, leading to disappointed patients and possible, but unnecessary, revision procedures later. In these cases, Dr. Pane strongly cautions patients to seek out a second opinion to verify whether the proposed procedure is likely to deliver the results the patient wants. Also, especially in revision procedures, proper aftercare and compliance with surgical staff directives can make a huge difference in both reducing the probability of postoperative complications and minimizing the appearance of scars. While scarring is not entirely avoidable, it can at least be moderated if the patient is diligent about following through on prescribed aftercare protocols and the avoidance of habitual and environmental factors which may otherwise irritate the area.

If you have a question about anything relating to cosmetic surgery, Dr. Pane and the staff of Atlantic Coast Aesthetics are always happy to discuss your concerns, interests, needs and points of curiosity…and we’ve made it really easy to find us! Simply call us at (561) 422-4116; email us at https://acplasticsurg.com; or follow us on Twitter, Facebook and Instagram. It’s even possible that your question might be the focus of an upcoming Ask Dr. Pane segment, helping us educate others with your interests and concerns while giving you the real, factual information you need to make a wise decision about your cosmetic surgery desires. Remember, at ACA, we believe the only bad question is the one you don’t ask!

RealSelf Patient Reviews of Thomas A. Pane, MD