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FAQs: Scarring After Breast Augmentation & Breast Implants - Post Op. Care

Scarring from Breast Augmentation - What Can I Do About It?

Scarring of the skin -OR- “Did the doctor do a bad job stitching me up?”

What is a Scar?

After a surgical incision, we make collagen to repair the gap. Collagen is just like cement filling the space between 2 bricks.Too much collagen is always made, but then we also make an enzyme called collagenase that melts the extra collagen. This molding process goes on for months. Collagen is made and the extra removed in a process designed to mold the original shape of the skin. If extra collagen is left, a thick scar is formed.

A perfect balance between collagen and collagenase will leave the least noticeable scar. Often, our healing process works too well! After the skin has re-formed, we keep on healing. If we could “turn up” the collagenase in our cells, we could melt the extra scar tissue.

Plastic Surgeons and Dermatologists have known for decades that there are ways to reduce scars. Until now though, none have been very convenient. Pressure bandages were found to help increase production of collagenase, our natural scar-melting enzyme, and have been used on burn scars for over a century. Cortisone Creams not only soothe irritated skin but also stimulate natural collagenase production. In extreme cases, doctors may use cortisone injections.

Doctors have prescribed Silicone Sheets for decades. Silicone sheeting taped over a scar will help reduce it. This was discovered in the early 80’s, when a doctor tried to apply pressure to a scar more evenly with a silicone gel sheet. The scars treated with silicone seemed to decrease much more rapidly. Vitamin E helps by working on the collagen fibers and makes a scar softer and more pliable.

Closing the Skin after Breast Augmentation Surgery

The first step in getting the best scar we can is the skin closure. Fortunately, most patients go to board-certified plastic surgeons for their surgery. For a plastic surgeon, closing the skin is like breathing. You have so much practice and training, it is second nature and there is truly very little difference from one experienced plastic surgeon to another.

I have had many patients come to me over the years to fix scars left by other surgeons. They are sometimes surprised when I explain to them that it looks like the incision was closed properly, but formed a bad scar anyway. This can happen.

After the skin is closed properly, what else can I do to lessen my scar?

For years, after the bandage or sterile strips were removed all you could do was cross your fingers. In 1938, Vitamin E was discovered. Over the past 20 years painting it on scars has been popular, but as I explain above, it softens them and doesn’t shrink them. There have been cortisones tapes and silicone gels and creams, all of which were helpful, but difficult to use because they were either messy or fell off.

I recommend a product called ScarGuard. This product combines all of the treatments that I described above into one liquid. It is a clear liquid that forms a fine flexible film within a few seconds after painting it onto the scar. This film helps to protect the scar from irritation while delivering silicone cortisone and vitamin E throughout the day. I have my patients start using ScarGuard right after the steri-strips or bandages come off. Treatment is continued twice a day for 3 to 6 months or until the scar has almost disappeared.

Nothing will completely remove a scar, and a few will heal badly no matter what we do, but I believe that using a product such as ScarGuard makes a very big difference in the end result.

What if I already have a bad scar from a past Breast Augmentation?

The first step is to see your doctor for an evaluation. Sometimes, a second minor surgery to revise the scar is advisable. If scar revision is not indicated then try using ScarGuard. ScarGuard works on old scars as well as new ones. If you undergo a scar revision, talk to your doctor about starting ScarGuard as soon as the bandages are removed.

This FAQ compliments of Joel R. Studin, M.D., F.A.C.S.

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