A breast lift or mastopexy can rejuvenate the breasts and restore their youthful appearance. However, a concern that patients often have is the development of scarring around the nipple. We reached out to experienced plastic surgeons to learn about how scarring occurs, what patients can do at home, and the range of in-office treatments available to address this concern.
Understanding the Nature of Areolar Skin
“The areola or the skin around the nipple is darker than the rest of the breast skin. Placing the areola on the breast can also contribute to the perception of symmetry between the two sides. Functionally, the areola and areola have contractile tissue that responds to different external stimuli such as touch and temperature. This can cause them to change shape and texture. They also have a higher density of nerve endings because of this and can be much more sensitive than the surrounding skin,” explains Pittsburgh plastic surgeon Leo R. McCafferty, MD.
Home remedies for scar healing
“Good surgical technique can help scars heal seamlessly. Tension control with wound closure is paramount. Often times, the signs look worse before they look better. Visible scarring around the areola should be expected after a mastopexy, and time should be given for the scars to heal,” advises Pittsburgh plastic surgeon Justin K. Williams, MD.
To help scars heal, Dr. Williams adds, “Early on in scar formation, scar massage and the use of a silicone-based scar treatment can be helpful. These do not cause immediate improvement, but can help to gradually soften the scar. I recommend it to every patient.”
In-Office Solutions
“Topical treatments are based on silicone, as this is the proven ingredient that helps improve the appearance of scars,” she says. Miami plastic surgeon Sean Simon, MD. “This can be in ointment form or silicone strips. I prefer the ointment as it can be applied as needed and is easier to use than the drop-on tape, which is very expensive and loses its stickiness easily.”
For more complicated cases, Dr. Simon suggests “Kenalog (injectable steroid) used to break up excess scar tissue as seen in keloid or hypertrophic scars. Typically, in my practice, this is used in preparation for a scar revision. When used to soften a thick scar before a revision, the chances of another very thick scar developing are reduced.”
Laser treatments
“As a rule, scar healing is better in and around the areola than breast skin if properly repaired,” notes New York City plastic surgeon Mokhtar Asaadi, MD. He recommends “massaging the scar with silicone gel and laser treatment for patients with light skin tones.”
Dr. Asaadi also emphasizes the use of lasers for specific conditions, stating, “In other cases, such as on an older, mature scar, I will often use an ablative laser such as a fractional CO2 to treat and improve scarring.”
Sometimes a combination of home treatments and various in-office procedures are required, but as experts noted, early intervention can improve the appearance of the scar. The advice of an experienced plastic surgeon is vital to the individualized treatment plan for breast lift scars.
