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Scarring and smaller nipple in one breast

Q:

I originally discussed with my doctor getting a breast uplift but I wasn't keen on the scarring.  He suggested a breast lift and also getting small implants, as the technique he suggested of cutting around the areola would leave minimal scarring.  Everything originally went fine except about a week after surgery, the stitches around my right breast opened and I was left with a gaping wound.  I had two options, get it re-stitched or leave it to heal itself.  We decided to leave it to heal itself; however, something happened with the healing process around the incision around the areola.  The scarring is very red and thick around this breast.  My other breast is perfect.  It has been six months since the operation and it is slightly better.  Instead of looking as if I have drawn a bright red circle around my areola, it now looks as if I have drawn a loud pink circle.  It is very unsightly.  Also, the nipple on this breast is smaller than the left one and is quite noticeable. I don't know what I can do now to correct this.  Please advise.

A:

I would recommend you return to your plastic surgeon to see what your options are for revision of the scar around your areola.  By allowing time for the scar to mature and soften, the widened scar can sometimes be removed leading to a better, less noticeable scar. Only after examining you can a good idea be given as to what your options are.

Dr. Edwards

A:

This may settle down by itself over the next several months.  Things like laser treatments, silicone sheeting and steroid injections may be helpful.  If you can't wait, the scar could be cut out and re-stitched at any point.

Bruce K. Barach, M.D. - View Other Answers by this Doctor
Schenectady, NY

A:

Unfortunately, problems like this occur. You made the right choice of letting the wound heal rather than trying to re-suture it.  Re-closure almost never works.  At six months with no other problems, you have two choices.  You can wait and see if the scar continues to improve to a reasonable appearance, or you can revise it.  If the scar is fairly thin (though it sounds as if yours is not), you should wait.  If not, I would revise the scar with long lasting buried sutures. 

A:

You need to wait awhile longer.  It takes at least a year for scars to mature and to see the "final" appearance.  At that point a discussion on what might be done to improve the appearance can be conducted.  Usually a scar revision can be done, which is a relatively straightforward procedure.  There are some scar treatments you can put on the scar that can be helpful.  Ask your surgeon about these.

A:

You have described a complication of a periareolar breast lift.  However, the fact that you feel your other breast "is perfect" is encouraging.  

You should see your plastic surgeon for re-evaluation.  Once the scar is soft and pliable a revision may be done. 

The scar is excised and the wound closed with sutures.  The nipple areola would be enlarged and after satisfactory healing, improved symmetry and appearance may be achieved.

Fredrick A. Valauri, M.D. - View Other Answers by this Doctor
New York, NY

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