Breast reduction surgery is truly a hybrid of a functional and cosmetic procedure. The functional benefits of breast reduction with respect to relief of shoulder pain, neck pain, and back pain are well documented [IL] and it’s a surgical procedure with a high overall patient satisfaction rate. Breast reduction scars, however, should not be overlooked as an important factor in deciding whether this procedure is right for you. Read on to learn the essential points about breast reduction scars that will help you know what to expect.
Breast Reduction Surgery Scars: Where Will They Be?
Breast reduction scars placement is determined by the specific technique used in your case. There are three main variations:
Liposuction Only Technique
This technique is generally reserved for younger patients with minimal sagging of their breasts and who need moderate reductions. The procedure uses a number of small incisions, usually about 1/4″ in length that are used to allow access of the liposuction cannula into the breast tissue so that fatty tissue within the breast can be extracted to decrease the overall volume and weight of the breast. The incisions can be placed strategically such as in the breast fold or around the underarm arm in order to make them even more inconspicuous.
Lollipop, Vertical Technique:
Scars are situated around the outer border of the areola and extending from the bottom of the areola vertically downward to the lower breast crease.
The lollipop breast reduction is intended for moderate to larger volume breast reductions and provides substantial lifting of the breasts as well. Very large breasts that are also very saggy may not shape well using the lollipop breast reduction, with an unsightly puckered area being left on the lower part of the breast.
Anchor-Pattern, Inverted-T Pattern
This technique has been a cornerstone of breast reduction procedures for decades, although its popularity has, to a great extent, been superseded by the lollipop procedure. Also known as the “inverted-T” technique, the anchor-pattern procedure produces scars around like the lollipop but with an additional horizontal scar across the lower breast crease. This procedure is done for breasts that need the largest volume reductions and most substantial lifting.
LARGER BREASTS USUALLY NEED SURGICAL TECHNIQUES THAT PLACE MORE SCARS ON THE BREASTS
Breast Reduction Scars: What Can They Look Like?
The placement of breast reduction scars on the breast is determined by the technique used for the procedure, but final scar quality is far less easy to predict. Scars from breast reduction are the final byproduct of complex interactions between genetics, personal healing tendencies, quality of surgical technique, and a smooth healing process. As such, the quality of scars from breast reductions can range from fine, thin, flat, and skin-toned all the way to the thick, raised, red scars known as hypertrophic and keloid scars, or the wide scars known as widespread scars.
Scar quality can also differ between the different incisions used on the same breast. It is not uncommon, for example, to see well-healed scars around the areola and vertical incision with anchor-pattern breast reductions with a thicker, ropier breast reduction scar-forming along the lower breast crease.
Absolute prevention of scars is not possible since all surgical incisions leave scars. The goal is, therefore, to optimize scars so that they are as minimal and cosmetically acceptable as possible.
Choosing A Reputable Surgeon
Surgical technique and decision making always plays a role in final scar quality and for breast reduction. Choose a board-certified surgeon who performs a lot of breast reductions and has a good reputation. Talk to your doctor about which breast reduction technique will work best for you.
Post-Operative Scar Prevention
Complications such as infection or accidental opening of stitches delay healing and may contribute to negative scar outcomes such as thick or wide scarring. Make sure to adhere to post-operative instructions provided by your doctor and refrain from physical activities and strenuous work for 4-6 weeks after surgery. It’s also critical that you don’t smoke cigarettes at all for at least 6 weeks prior to and 6 weeks after surgery since nicotine increases the chances of major healing complications dramatically [l]. Consider the use of high-quality scar products such as silicone gels and strips and scar creams to decrease the likelihood of hypertrophic scars and keloid scars.
Breast Reduction Scars After 2 Weeks:
Barring wound healing complications, breast reduction scars after 2 weeks will be healed and stitches or staples will be taken out around this time. This is also the point at which most breast reduction surgeons will recommend commencing the use of anti-scarring creams, gels and tapes and massaging scars to help soften and de-sensitize them. Don’t be alarmed if the incisions are itchy red, and highly noticeable at this stage because healing has just begun and, in reality, it’s about a year-long process overall. Furthermore, at 2 weeks the breast shape is often unusual and awkward in appearance due to swelling and other factors.
Breast Reduction Scars After 2 Months:
When it comes to scarring quality, the passage of time usually leads to fading, flattening, and overall improvement in scars. That said, many patients will also observe that their scars seem to be getting thicker redder for the first couple months. Breast reduction scars after 2 months are usually just beginning the process of softening, lightening, and fading and will generally improve a lot over the next year or so.
Breast Reduction Scars After 6 Months:
After 6 months, scars will have had the benefit of months of healing time and will be well on their way to their final appearance. In most cases, 6 months of healing will have led to major softening and lightening of the scars and tenderness, the itchiness will be gone or only minimal. The majority of patients have very much “moved-on” from their breast reduction procedure at this point, appreciating the tremendous benefits of decreased neck and back pain, and improved ability to exercise comfortably and fit into standard-sized bras and tops. There are, however, a significant number of breast reduction scars at 6 months will show increasing signs of being hypertrophic scars that are red, raised, thick, and possibly persistently itchy and tender [l]. A much smaller number of patients, especially if prone, will have developed dreaded keloid scars at this point in healing.
Breast Reduction Scars One Year Later:
Final outcomes of breast reduction scars are reasonably clear one year later. Patients that developed hypertrophic scars [l] very often will have benefited from the passage of time and the scars will have matured to become much flatter, faded and devoid of itchiness and sensitivity. A smaller group of hypertrophic scar formers whose scars failed to improve and those unfortunate enough to have healed with genuine keloids will need interventions such as cortisone injections, prolonged use of silicone products, laser treatments, and other modalities.
IT WILL TAKE MONTHS FOR BREAST SHAPE TO BECOME MORE NATURAL AND SCARS TO BEGIN FADING
Breast reduction has as high as a 95% patient satisfaction rate regardless of their initial cup size. The quality of life improvements in terms of pain-relief and freedom to exercise comfortable and choose new styles of clothing has made breast reduction surgery on of the most popular plastic surgery procedures today. Sub-optimal scar quality has been shown to be the number one factor leading to revisionary surgeries with up to 15% of breast reduction scars being hypertrophic in nature, particularly breast crease incisions used in the anchor pattern/inverted T technique.
Gonzalez MA, Glickman LT, Aladegbami B, Simpson RL. Quality of life after breast reduction surgery: a 10-year retrospective analysis using the Breast Q questionnaire: does breast size matter? Ann Plast Surg. 2012 Oct;69(4):361-3. doi: 10.1097/SAP.0b013e31824a218a. PMID: 22964671.
Saleem, Lakshmi, and Jerry R John. “Unfavourable results following reduction mammoplasty.” Indian journal of plastic surgery : official publication of the Association of Plastic Surgeons of India vol. 46,2 (2013): 401-7. doi:10.4103/0970-0358.118620