Tips to Minimize Your Breast Reduction Scars

Breast reduction is a safe, surgical procedure that improves the lives of many women who have uncomfortably large breasts. As with any type of surgery, you can expect breast reduction scars after the procedure. After a breast reduction performed by an experienced plastic surgeon, a true breast specialist, women find themselves with relief from back and shoulder pain, better posture and a higher level of self-confidence, all of which allow them to live a more active lifestyle. That’s a pretty great list of benefits, so it’s no wonder that breast reduction is a popular plastic surgery procedure, even though scars are involved.

The Scar Trade-Off in Breast Reduction

To achieve the benefits that come with a breast reduction surgery, also called reduction mammoplasty, there are some trade-offs. Perhaps the most significant is breast reduction scars. Typically, scars are a bigger concern prior to a woman undergoing breast reduction surgery. Afterward, the vast majority of women are extremely happy with their results, which makes the scarring well worthwhile for most women. After all, scars are generally not visible–even when you are wearing low-cut clothing or beachwear.

Are Breast Reduction Scars Inevitable?

There have been attempts, over time, to develop methods of breast reduction with minimal scarring or only tiny scars. Unfortunately, if you minimize the cutting, you minimize the result. A certain amount of breast tissue removal is needed to achieve a successful breast reduction. Whenever there is cutting or tissue injury, there will be scars. They are a natural part of healing that occurs after any damage to the skin or other body tissues.

What Type of Skin Gets the Worst Scarring?

The amount of scarring you end up with depends upon a combination of these details:

• Age: Skin tends to heal more slowly as you age, which makes scarring more likely.
• Skin Color or Race: Women with relatively dark skin or very light skin may have more visible scarring.
• Location: Scars in the skin above joints, where lots of motion takes place, will cause more or larger scars. (Not a problem with breast reduction, provided you keep tension off your incisions by following your surgeons recommendations for avoiding upper body exercise, driving, pulling and lifting, etc., until you are healed.)
• Complications During Healing: Excess swelling or infection can worsen scarring.
• Smoking: Smokers heal more slowly and typically experience more scarring.
• Heredity: Wound healing and scarring have a genetic component.

Where Do Breast Reduction Scars Show Up?

Breast reduction scars (and the incisions that cause them) are generally in a “lollipop” or “anchor” configuration: a circle around the edge of the areola and a straight line vertically down the center of the breast from the circular scar; with or without a scar curving along the breast crease.

If a larger amount of tissue is being removed, incisions are typically made in a “keyhole” or “angel” shape. A semicircle of skin is cut above the nipple (this is where the nipple will be relocated, higher on the breast) and the incision extends from each side of the semicircle down to the breast crease. The actual, final scar will be much smaller than these incisions indicate, however.

After excess breast tissue is removed in the reduction procedure, your NJ breast surgeon stitches the remaining skin together to create the smaller breast. When completed, the skin is closed to form the “anchor” or “lollipop”shape. The latter part of the scar is hidden around the edge of the areola. (In some cases, the areola is made smaller during a breast reduction.) The most obvious part of the scar is the vertical line, which often becomes a thin, white line once healing is completed.

Is There a Short-Scar Breast Reduction?

Not an effective one. Other techniques have been tried, leaving only a scar around the areola. This can leave the breast in an unnaturally flat state and/or only allow a tiny reduction, which misses the point of the surgery entirely. Liposuction alone cannot make much of a reduction before it begins to leave sagging skin. (Sagging breasts would need to be corrected with a breast lift, and you would therefore end up with the same scars as a typical breast reduction.) So for most women, the anchor or lollipop scar is most effective for breast reduction.

Your plastic surgeon will discuss this in more detail, showing you how the details relate to your specific anatomy. Then you can decide if the benefit of the reduction is worth the trade-off of the scar for you, personally. The more breast shaping and reduction you need, the more scar you will have. With more shaping, however, the end result is a better shaped breast. As mentioned, for most women, the surgery is successful and the scar isn’t much of a concern once the overall breast reduction result is seen.

Minimizing the Look of Breast Reduction Scars

Here is your to-do list to help breast reduction scars heal quickly and well, so that they become less and less visible over time:

• Wear your tension dressing (surgical support bra) as directed. You will wear it 24 hours a day for several weeks, removing only to shower, which is allowed after the first day or two. Always check with your NJ plastic surgeon for the timing that fits your case best. Once the surgical bra is no longer required, you will move to a sports bra.
• Use steri-strips: You will likely keep these on (or surgical tape) for the first week or more.
• Sleep with your torso propped up as directed by your surgeon. This limits swelling and limits tension on the scars. Any tension can make scars wider.
• Keep your friend close by: A friend should drive you to and from surgery–and also spend the next day or two with you. The friend can help you walk around safely so that you don’t fall and risk re-opening your incisions. Your pal can get you food and drink, walk you to the bathroom, etc., and keep you from straining or injuring yourself or your stitches.
• Care for your incision: You can typically shower after the second day, but get your surgeon’s OK. Don’t immerse incisions in water (such as a bathtub). Use only surgeon-supplied or approved ointments or creams on your incision. Watch for signs of infection, excess bleeding or excess inflammation, fever and chills. Call your surgeon if anything worries you.
• Limit salt intake if your surgeon advises you to do so. This may limit swelling.
• Stay hydrated and eat healthy, fresh foods so that your body has the nutrients and energy it needs to heal properly.
• Avoid medications not approved by your surgeon: Don’t take aspirin, fish oil, vitamin E (which thin your blood) and other drugs or supplements that your surgeon may ask you to avoid.
• Avoid alcohol: It can cause fluid retention.
• Don’t raise your blood pressure: This could delay healing and/or cause bleeding, so no major workouts for the first 4 to 6 weeks. A small amount walking is good, but no running and no upper body exercise.
• Don’t place strain on incisions: You must not lift, push or pull with your arms. Keep the elbows next to your body so that you remember not to reach for anything far away and place tension on your incisions/stitches. This includes no driving for at least a week.
• Massage: Your surgeon may recommend massaging to soften scars after incisions are healed.
• Keep scars out of the sun for as long as possible and wear sunscreen to prevent scars from darkening.
• No swimming for about 6 weeks, until your scabs are gone and you’ve got the OK to exercise your upper body.
• Steroid injections: Your surgeon will provide these if needed during your recovery. Your surgeon may prescribe or recommend a steroid cream.
• Scar sheets: Your surgeon may recommend silicone sheets or scar gel to be used for six months to year.
• Laser skin treatments can help to blend the scar into the background. Do this only after healing is well under way, at least a month or more after surgery, with your NJ plastic surgeon’s recommendation.

Choose Your Surgeon Wisely to Minimize Breast Reduction Scars

Your breast surgeon makes a big difference in the outcome of your surgery and your scars. When you choose an elite plastic surgeon for your breast reduction, your surgeon will:

• Plan your surgery around you: The plan will encompass your specific goals for the breast reduction, along with your anatomy/body size, age, skin elasticity and more. Your surgeon can show you in advance where and about how long your scar will be.
• Place incisions carefully so that scars will be invisible when you’re clothed.
• Use the smallest incisions possible for an optimal breast reduction outcome.
• Use advanced suturing methods to close incisions completely without excess tension. This allows them to heal well and minimize breast reduction scars.
• Treat breast tissues gently during surgery to avoid unnecessary trauma, which can lessen the scarring that will result.
• Preserve the blood supply and nerve function to the breast and nipple. This will keep tissues and skin healthy as well as promote healing.

If you’re considering a breast reduction but are concerned about scarring, we urge you to choose a top breast surgeon–one with whom you can communicate clearly to get the results you want. Our office offers a personalized consultation to help you learn about your options for breast reduction. Simply contact Cohen/Winters Aesthetic & Reconstructive Surgery in Bergen County for an appointment.