How long will my breast reduction scars take to heal?

I had an anchor incision breast reduction 4 months ago and followed all my doctor's recommendations to reduce scarring (silicone sheets, scar massage). I was told that the scars would be minimal but they're still very red and fleshy. Is there anything more I can do or will the scars from my breast lift be there forever?!

SeaLioness

F, 35, Texas

With surgical wounds, certain individual factors will bear an influence on scarring. Every individual heals differently, and while it is excellent that you have closely followed your surgeon's recommendations, genetics, ethnicity, and age can all figure in how your breast reduction scars heal.

There is a range of factors that will influence the formation of your scar:

  • Women with darker skin are 15 times more likely to experience abnormal scarring, such as keloid scarring, where the skin becomes raised, hard and can be itchy; or hypertrophic scarring, where the skin feels thickened around the incision site and is red.
  • Genetics may also dictate your predisposition to scarring. If you have a family history of abnormal scarring, this may impact how your wounds heal.
  • Prominent scarring can also occur if the incision was sutured with too much tension.
  • If you experienced any infection of the wound during the early postoperative phase, this may delay healing and increase the risk of abnormal scarring.

It’s important to acknowledge that breast reduction surgery necessitates scarring to achieve optimal aesthetic results. The anchor incision technique is most commonly used for women with extremely large breasts or severe breast ptosis, and has more incisions than other reduction techniques, such as the short scar technique.

While breast reduction patients should ideally heal with minimal scarring that becomes a very fine, almost imperceptible line over time, this is not the case for every patient. Many women who do have some scarring accept that the scars are the trade-off for the improvement in breast size, contour, breast symmetry, and a reduction in neck and back pain.

It may be worthwhile booking a follow-up consultation with your surgeon to confirm that your scars aren't abnormal, and to check on your healing process. Your surgery was still relatively recent and it could take up to 12 months before your final results are apparent. In the meantime, continue with the scar reduction techniques you are using and avoid smoking, tanning, and excessive scrubbing or itching of the area as these may exacerbate scarring.

In the long run, if your scars are still overly dark or thick, fractionated laser can help improve their appearance.

Dr. Kimberly Henry has 2 Breast reduction before & afters:

Breast reduction before image performed by Dr. Kimberly HenryBreast reduction after image performed by Dr. Kimberly HenryBreast reduction before image performed by Dr. Kimberly HenryBreast reduction after image performed by Dr. Kimberly Henry

» View Dr. Kimberly Henry's full profile

By keeping up with your aftercare appointments and following your doctor’s recommendations, scars heal into thin, flat lines over the span of about a year. The final result can vary depending on factors such as skin color. Darker skin tones are more prone to developing keloids and hyperpigmentation. For best results, avoid infection and do not smoke; These things can cause scars to widen. Women who undergo breast reduction can wear virtually anything. In my experience, even undressed, after about a year, the scars are difficult to see if you aren’t specifically looking for them.

The healing time and the end result of your healed breast reduction scars depend on a few different factors. The main determining factor is the technique that you and your doctor choose to use for your reduction. My doctor used the traditional technique for my surgery. The first several months the scars are red and bumpy and were fully healed and flattened out after about a year. 

The traditional technique uses the most incisions, due to the large horizontal incision across the crease under the breasts. While this does leave a long scar on each side, it is strategically placed in an area that is covered by the band of your bra, swimsuit, etc., making it only visible if you happen to be looking for it. 

The vertical technique eliminates the largest scar of the traditional technique. The only visible incision is the vertical scar going from the crease up to the areola and outlining the perimeter of the nipple. There is now the liposuction technique available in some cases, which uses only a small incision the liposuction is inserted through, leaving very minimal scars. 

The scars associated with an inverted-T or anchor breast reduction have one additional scar when compared to the vertical breast reduction. This extra scar is very thin and runs along the crease just beneath the breast. This technique is used when a large amount of tissue must be removed and significant reshaping is needed.

The scars are permanent and are aligned to allow for easy concealment with clothing or a bikini top. These scars will fade significantly within the first year with proper care. Follow all of the surgeon's wound instructions exactly as they are given. Keep the incisions clean to avoid infection. Avoid exposing the incisions to the sunlight to prevent hyperpigmentation.

Silicon strips may be used to treat the incision sites as well. Keep all of your aftercare appointments. Laser treatments may be recommended to prevent hypertrophy or the formation of raised, red scars known as keloids. Prescription creams may also be prescribed.

After a breast reduction, your scars can take up to a full year to be completely healed. Most of the healing will happen in the first three months after the surgery, but you’ll see the scars get lighter and flatter over a period of a year. Once a year is up, they are pretty much as healed as possible. Fair skin generally scars better than darker skin and darker skin is also more prone to keloid or hypertrophic scars. You can use a topical scar treatment with silicone and vitamin E to help the scars fade and to help them flatten. While you’re in the healing process you shouldn’t tan your scars because that can cause them to heal darker permanently. If your scars do heal darker than you want them to be, you can lighten them with laser treatments, or your surgeon can do a scar revision. Laser is usually really effective at lightening scars, but if they’re raised as well as pigmented, your surgeon may revise them by removing the old scar and restitching the incisions.