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Is breast augmentation advisable for someone who has keloids from previous surgeries?

Q:

I am a 46 year old female of East Indian origin. I would like to have a breast augmentation and lift. I have a keloid from a rotator cuff surgery. Should I be concerned about keloids post breast augmentation & breast lift surgery?  Also, what is the ideal incision area to decrease any scarring?

A:

Yes, if you have a history of keloids or hypertrophic scars you should definitely be concerned about this occurring with a breast lift or breast augmentation. Please remember that a keloid is often described as a type of scar that grows out and encompasses/takes over normal surrounding tissue. This type of scaring is more common in patients of African decent and some Oriental populations like Koreans but, can occur in almost any race/culture. A hypertrophic scar is a scar that raises up within the confines of the incision/scar. This type of scaring usually responds to conservative treatment approximately 86% of the time while keloid scars have a very high recurrence with success rates of reduction/removal of approximately 36%. Hypertrophic scars can be more common on certain parts of the body like the shoulder.

The ideal incision with someone who has your history would be a transaxillary incision for breast augmentation. However, this most likely will not address a sagging or ptotic breast. May I suggest you consider a consult with an ASAPS member that has patients' post operative photos who have your problem so that you can make an informed decision as to what you want to do.

Best,

Gary R. Culbertson, MD

A:

Scarring is genetically inherited and thus if you have the gene for keloids your scars have the potential for keloid formation. An appropriate diagnosis of the keloid scar is important and a consultation with a board certified plastic surgeon will be of great help.

Some areas of the body have a tendency to form a thick scar, but not necessarily a keloid.

S. F. Shureih, MD

A:

Keloids and Breast Augmentation

If one is prone to keloids then one needs to be very careful, as this poses a different risk with all procedures, especially with patients of color. It is important to consider the incision location and placement carefully in these patients.

R. H. Rohrich, MD

A:

First you should be seen and examined. Many times patients have hypertrophic scars which are not keloids. If your scarring is unfavorable then you have to evaluate the incisions used by the surgeon and the ability to minimize the incision such as a periareolar incision for palcement of the implant and then a mast openly or lift using the same incision. This of course is determined by your exam.

R. Whitfield, MD

A:

I recommend you first see a board certified plastic surgeon to evaluate your scar, as it may not be a keloid but simply an unfavorable scar. The surgeon would be able to consult with you about your risks for keloiding. If you do have a keloid from the prior surgery you should be careful about committing to the incisions on your breasts which may result in a keloid there as well.

J. M. Darrow, MD

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