Any time surgery is performed, a scar is left behind. Breast augmentation is no different. Incisions usually heal well, but it never hurts to try to help the healing process along so that the best result possible is achieved.
Any injury to the body outside of a superficial wound (scratch, small cut, etc.), results in scarring. A scar is comprised of fibrous tissue composed of collagen. Under normal conditions, the body replaces the broken down collagen with new collagen fibers at a rate that is in balance with the breakdown of the old collagen. Normally, this results in a scar that is flat, usually with coloring very similar to our natural skin pigment.
A small portion of the population is prone to keloid or hypertrophic scarring, which require treatment since they are very noticeable.
Whether you're prone to keloid or hypertrophic scarring or not, it certainly does not hurt to help your incisions along by treating them with products aimed at aiding the healing process.
Scars in younger people tend to have more pleasing results than in older people. This is due to the fact in younger people, collagen is produced at a faster rate.
Hypertrophic and Keloid Scarring
A hypertrophic scar is a raised, thick scar at the site of injury. This type of scar does not extend outside of the injured area. Hypertrophic scars are usually associated with burn victims, as more than 90% of burn victims have this type of scarring. The most common areas include the shoulders, knees, necks, ankles, and presternum. The presternum area is the upper area of the chest above the breasts. Even though the armpits, belly button, breast itself, including the crease area, are not areas that are typically predisposed to hypertrophic scarring, you should be sure to inform your plastic surgeon if you have any sort of history with hypertrophic scarring. Just because these areas aren't in the "most common" areas seen with hypertrophic scars, it does not mean that those areas won't scar that way.
Hypertrophic scars usually occur one to two months after surgery. They grow rapidly for a period of up to six months, then gradually recede over a period of a few years, eventually resulting in a flattened scar.
Incisions that are too tightly closed, or areas of the body which has a lot of tension on the skin, are more susceptible to hypertrophic scarring.
Keloid scarring is the worst type of scarring. These scars are similar to hypertrophic scars except that they extend beyond the area of injury. They are often shiny in appearance, darker in appearance than the surrounding pigment, and can grow very large. They can also feel somewhat tender (sore) to the touch. Fortunately, most people are not predisposed to this type of scarring, although certain populations with darker skin tones do seem to be more prone. Even if you do not have a darker skin tone (African American, Latino, Asian), it is important to remember that keloid scarring can occur in all races.
Keloid scarring can develop within years after the injury. In other words, they may not appear shortly after surgery, but can appear much later on. These scars have a long growth phases and do not recede on their own.
Getting the Best Scar Possible
Whether or not you're prone to keloid or hypertrophic scarring, it is always a good idea to be proactive when it comes to helping your incisions heal. There are a lot of options available in scar treatment.
Silicone sheeting, which has been around since the 1980's, is often a favorite type of treatment. One study showed that 85% of the scars in 20 cases improved after wearing the sheeting for at least 12 hours per day.1 It is recommended that the sheeting be worn for a period of at least two months, beginning two-weeks after wound healing.2
Rejuveness is a popular brand of silicone sheeting, especially among breast augmentation patients. Rejuveness's sheeting comes in special shapes for various types of surgery, including breast augmentation/breast lift surgeries. This sheeting is self-adhesive, and are re-usable. They can be washed and reapplied daily for up to three months. Rejuveness offers varying sizes of sheeting which is very helpful since everyone is different and not everyone shares the exact same need.
Rejuveness Sheeting for Crease Incisions
Rejuveness Sheeting for Full Anchor Lift Scars
Rejuveness Sheeting for Lollipop Lift, Benelli Lift, or Areola Scars
This sheeting comes in the shape below, but also comes in circles only, which can be used for Benelli lift incisions and for regular areola incisions (w/o a breast lift).
New Gel Plus and Biodermis also carry silicone sheeting in special shapes designed specifically for breast incisions. Other brands of silicone sheeting include Cica Care, and Mepiform, which can all be purchased on Amazon.com, ScarGuard's ScarSheet, and ScarAway, which can often be found at your local drug store. Unfortunately, these other brands do not come in the special shapes that Rejuveness offers.
Silicone Gel Treatments
Silicone gel treatments are also very popular with plastic surgery patients. Silicone gel treatments are painted on like nail polish, and are self-drying. It is usually painted on once or twice a day. This type of treatment has shown to be very effective on improving the look of scars.
ScarGuard, a long-time favorite among plastic surgery patients, comes in two different formulations: one for flattening and shrinking existing scars, and one for lightening dark scars. This brand has been popular for quite a while, and has shown to give good results.
Kelocote is another brand of silicone gel treatment that has been around for a long time and has a reputation of being very effective.
There are a multitude of gels available for purchase, but be careful to read the reviews first, as some products are not as established nor effective as ScarGuard and Kelocote.
Other Scar Treatments
If you have a television in your home, you're familiar with Mederma, or at the very least, you've heard of it. Mederma does not contain silicone gel. Instead, the active ingredient is the common onion. Yes, the same onions you find in your supermarket. Onions contain bioflavinoids that may be conducive to helping heal scars. However, reviews on this product have shown to be mixed. One study involved one group using the onion extract, one group using petrolatum jelly. After 12 weeks, the study concluded that onion extract did not improve the look of the scar when compared to a petrolatum-based ointment.3 However, others have reported success with this product. As with any product, there will be "hit and miss" situations. Some products will work for some people, while they won't for others. It is a gamble, and you just have to find the one that works best for you
1. Fulton, JE, Jr. PubMed. "Silicone Gel Sheeting For the Prevention and Management of Evolving Hypertrophic and Keloid Scars." 1995.
2. Gerd G. Gauglitz, Hans C. Korting, and G. Jeschke. National Institute of Health. "Hypertrophic Scarring and Keloids: Pathomechanisms and Current Emerging Treatment Strategies."
3. Chung VQ, Kelley L, Marra D, Jiang SB. National Institute of Health. "Onion Extract Versis Petrolatum-Emolient on New Surgical Scars: Prospective Double-Blinded Study.