Minimising Scarring after Breast Surgery

Minimising Scarring after Breast Surgery

Breast surgery can be performed for various reasons, ranging from cosmetic enhancements such as augmentation mammoplasty and lift mastopexy, to medical necessities like mastectomies or lumpectomies for breast cancer treatment. While these procedures can offer many beneficial outcomes, they often leave behind scars that can cause physical discomfort or distress. In many cases, scars can make the recovery journey more challenging. Fortunately, several strategies can help reduce the visibility and impact of these scars, enhancing the overall results of the surgery.

Specialist Plastic Surgeon Dr Jeremy Hunt has devoted his career to helping patients achieve the aesthetic outcomes they desire. He understands the physical and emotional toll that scars may impose. Dr Hunt’s compassionate care extends to all his patients, providing them with the information and support they need to confidently navigate their recovery journey.

Download Dr Hunt’s Guide to Breast Surgery

Standard Breast Surgery

Types of Breast Surgery Procedures

There are many types of breast surgery procedures, each with its own potential for scar formation. Breast Augmentation Mammoplasty involves placing implants to increase breast size, which can result in scars either around the nipple, under the breast crease, or in the armpit.

Breast reduction mammoplasty surgery is performed with the aim to reduce the size of large breasts, with scars forming around the nipple and down the lower portion of the breast.

A breast lift mastopexy procedure is performed to raise sagging breasts, and it commonly leaves a scar around the nipple, vertically down to the breast crease and along the crease itself.

For women who’ve undergone a mastectomy due to breast cancer, breast reconstruction surgery can be an option. This procedure often leaves scars, but their location can vary depending on the specific surgical technique used.

Surgical Approaches and Incisions for Breast Surgery

The type and location of incisions made during breast surgery significantly influence the appearance of scars. Some common surgical approaches include:

  • Periareolar incision: An incision made around the edge of the areola, which is often used in breast augmentation mammoplasty, reduction mammaplasty, and lift mastopexy surgeries
  • Inframammary incision: An incision made in the crease under the breast, often used in augmentation mammoplasty and reconstruction surgeries
  • Transaxillary incision: This type of incision is made in the armpit, used primarily for breast augmentation mammoplasty
  • Vertical or “lollipop” incision: Used in breast reduction mammaplasty or lift mastopexy surgeries, it involves an incision around the areola’s edge that goes down vertically to the breast crease
  • Wise pattern or “anchor” incision: Often used in very large breast reduction mammaplasty or in mastopexies where the breast is extremely ptotic. The incision lies around the areola, vertically down the front of the breast and horizontally in the breast crease.

Factors Influencing Scar Formation

Scar formation after breast surgery can be influenced by various factors:

  • Genetic predisposition: Some individuals are naturally prone to form more noticeable hypertophic or keloid scars
  • Surgical technique: The plastic surgeon’s skill and the chosen surgical method can impact scar visibility
  • Post-operative care: How well you care for the wound after surgery can significantly influence scar formation
  • Lifestyle factors: Smoking and exposure to sun can exacerbate scar formation
  • Nutrition: Good nutrition is vital for proper wound healing and minimising scar tissue formation

How to Prepare For Breast Surgery to Prevent Visible Scars after Surgery

Preparing for breast surgery with the aim of minimising visible scars is an essential part of your surgical journey. Here are some steps you can take:

  1. Choose an experienced surgeon: Choosing an experienced surgeon is crucial. They should have extensive knowledge of the best surgical techniques to minimise scarring and of proper wound care post-surgery
  2. Discuss the surgical approach: Talk to your surgeon about the type of incisions they plan to make
  3. Quit smoking: If you are a smoker, it’s highly recommended to quit at least a few weeks before the surgery. Smoking/vaping can slow down your recovery and increase the risk of visible scarring
  4. Preoperative consultation: Discuss with your surgeon any concerns you have about scarring, and learn about the strategies that can be implemented both during and after surgery to minimise scars

Download Dr Hunt’s Guide to Recovery

Rapid Recovery

What to Avoid After Breast Surgery to Minimise Scars

Postoperative care is just as important as preoperative preparation when it comes to minimising scars after breast surgery. Here are some things to avoid to ensure the best possible outcome:

  • Avoid stress on the incision site: Avoid any activities that could put stress or strain on the incision site, especially in the early recovery phase. This includes heavy lifting, rigorous exercise, and stretching movements that may pull at the sutures
  • Don’t smoke: Smoking/vaping can significantly hinder the healing process and lead to worse scarring. It’s crucial to avoid smoking/vaping for several weeks post-surgery
  • Avoid sun exposure: Protect your scars from the sun, as UV radiation can darken scars and make them more noticeable. If you need to go outside, wear protective clothing, or apply a strong SPF sunscreen to the scar area once it has fully healed
  • Avoid picking at scabs or stitches: Picking at scabs or stitches can interrupt the healing process and potentially lead to worse scarring. If your stitches are causing discomfort, consult your surgeon rather than trying to handle it yourself
  • Don’t neglect proper nutrition: Continue to eat a diet rich in nutrients that support healing and healthy skin
  • Avoid dehydration: Keeping your body and skin hydrated can support the healing process, so try to avoid becoming dehydrated
  • Avoid swimming and baths: Soaking your incisions in water can lead to infection and negatively impact wound healing. Stick to showers until your surgeon gives you the go-ahead
  • Avoid alcohol: Excessive alcohol can impair wound healing, and can also interact with post-surgical medications. It’s best to limit or avoid alcohol in the weeks following surgery

Surgical and Non-surgical Scar Reduction Methods

Several surgical and non-surgical methods can be utilised to reduce scars post breast surgery:

Surgical methods include scar revision surgery, where the surgeon removes the scar and re-closes the wound, and fat grafting, which involves injecting small amounts of fat into the scar to minimise its appearance. The surgical methods to reduce or modify the appearance of scars can vary, depending on the type, location, and age of the scar, as well as other factors like the patient’s health and lifestyle. Here are two common surgical techniques:

  • Scar Revision Surgery

In this process, the existing scar is surgically removed, and the skin is re-sutured to heal in a less noticeable fashion. This can be done through a few different techniques.

  • Fat Grafting

Fat grafting, also known as fat transfer or lipofilling, can help improve the appearance of depressed or atrophic scars. This procedure involves collecting a small amount of fat from another part of the body (like the abdomen or thighs), processing it, and then injecting it into the scar area. The injected fat can help elevate the depressed scar, making it level with the surrounding skin surface and thus less noticeable. In addition, fat grafting can also help improve the scar’s texture and colour, making it blend better with the surrounding skin.

Non-surgical methods include:

  • Topical treatments: Creams, gels, and silicone sheets can help in reducing scar visibility. Silicone sheets or gels are particularly effective as they keep the scar hydrated and protect it from excess sunlight, enhancing healing and minimising scar formation
  • Laser therapy: This treatment can reduce scar thickness and redness. The laser breaks down scar tissue and stimulates the body’s healing process, leading to the formation of healthier skin
  • Steroid injections: These are used for hypertrophic or keloid scars and can help reduce their size and alleviate discomfort
  • Massage: Gentle scar massage can help break down scar tissue and improve flexibility, especially in raised or thickened scars

Remember, the most suitable scar reduction method depends on the type of scar. Therefore, it is always best to consult a medical professional or a trained plastic surgeon like Dr Jeremy Hunt for personalised advice on scar reduction. They can guide you through the process, ensuring you understand the expectations and results of each method.

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FAQs about Scars after Breast Surgery

When is scar revision surgery needed?

  • Scar revision surgery is usually considered when a scar causes physical discomfort or restricts movement, when the scar is aesthetically displeasing or causes distress, or when non-surgical methods have not been effective. Scars that have healed in a way that is noticeably misaligned with the skin’s natural tension lines, keloid scars (which are raised and extend beyond the original wound), or hypertrophic scars (which are thick and raised, but do not extend beyond the original wound) can often benefit from scar revision surgery.

Can scars from breast surgery be completely eliminated?

  • While the goal of scar management strategies is to make scars as unnoticeable as possible, it’s important to remember that scars are a natural part of the body’s healing process. As such, they cannot be completely eliminated. Surgical and non-surgical methods can significantly reduce the appearance of scars, making them less noticeable and more aesthetically pleasing. The results vary depending on the individual’s healing capabilities, the location and type of the scar, and the treatment method used.

How long does it take for breast surgery scars to heal?

  • Healing times for breast surgery scars vary from one patient to the other. In most cases, initial wound healing occurs within 2 weeks, during which time the incision site should be carefully protected. Over the next few months, the scar will typically become darker and harder – this is a normal part of the healing process. Over the next 1 to 2 years, the scar will usually soften and fade, although it may not completely disappear.

What are my options to get rid of scars after breast surgery?

  • You have several options to manage scars after breast surgery. Topical treatments such as silicone sheets and creams, and injectable treatments like corticosteroids, can be used. For more noticeable scars, laser therapy or microneedling can be beneficial. Surgical options, such as scar revision surgery or fat grafting, may be considered for more severe or problematic scars.

Can natural remedies help reduce scars?

  • Natural remedies can sometimes help with scar management, although their efficacy varies and they are typically less effective than medical treatments. Aloe Vera is known for its healing properties and can soothe the skin and reduce inflammation. Vitamin E oil, when massaged into the scar, can help improve the scar’s elasticity and appearance.

Further Reading about Breast Surgery with Dr Hunt

Medical References about Breast Surgery and Scars

About Dr Jeremy Hunt – Specialist Plastic Surgeon

Dr Jeremy Hunt

Dr Jeremy Hunt is a specialist plastic surgeon and a member of FRACS & ASPS. He has over 20 years of experience providing plastic surgery in Sydney.

The one-on-one service and attention to detail from Dr Hunt, has ensured that thousands of women and men from the Sydney & Wollongong NSW area and across Australia have received high quality surgical care.

Dr Hunt’s qualifications and education

Dr Jeremy A Hunt MBBS FRACS graduated with a Bachelor of Medicine degree from Sydney University in 1990 and is a Fellow of the Royal Australasian College of Surgeons and member of ASPS – the Australian Society of Plastic Surgeons. He completed a Fellowship at the prestigious University of Texas in the United States, where he learnt from some of the world’s very best plastic surgeons.

Next Step – Make an Enquiry or Request a consultation with Dr Hunt

Would you like more information before scheduling your consultation?

Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health professional.

Symptoms of Ruptured Implants

Symptoms of Ruptured Implants

The majority of breast implant ruptures cause no symptoms or health problems and can remain undetected for a long time. Nevertheless, many patients wonder how they can know if their breast implant is ruptured. And what are some of the signs of a ruptured breast implant.

A saline-filled breast implant will usually shrink and deflate when it’s ruptured. You may experience a sudden or gradual change in the size and shape of your breast, an abnormal breast shape, and pain in case your saline implant leaks.

At the same time, a ruptured silicone implant doesn’t shrink and usually doesn’t cause any symptoms. However, it can be detected with a breast MRI or ultrasound. Less commonly, when a silicone gel implant ruptures, it can cause pain, breast lumps, thickening in the breast, and changes in the breast contour.

Dr Jeremy Hunt is a specialist plastic surgeon performing breast surgery in Sydney, Australia.

What Causes a Breast Implant To Rupture?

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A breast implant can be either silicone-filled or saline-filled. Either way, all types of implants have an outer silicone shell that rarely becomes torn or punctured causing the implant to rupture.

The following may cause a ruptured breast implant with any type of filling:

  • Normal ageing of the implant: implants are not permanent devices. With time, the implant shell starts to wear down. As a result, the older the implant, the higher the chances it could rupture
  • Damage during surgery: this is the most common cause of a ruptured breast implant. During a breast augmentation mammoplasty or breast reconstruction surgery, if a sharp surgical instrument comes in contact with the implant, it can micro-cut the implant shell and eventually cause it to rupture
  • Trauma to the chest: a blunt force trauma to the chest, such as the one experienced in a car accident, for example, may cause a breast implant to rupture
  • Needle insertion during a biopsy: during a breast biopsy, a biopsy needle is inserted into the breast tissue to collect tissue samples. Although a needle biopsy is safe in patients with breast implants, it needs to be performed by someone with a lot of experience to avoid puncturing the implant and rupturing it in the process
  • Shell swelling: the implant’s shell can become weak if silicone leaks from the filling into the shell. Consequently, the shell will swell, weaken, and become more vulnerable to rupture
  • Mechanical pressure: in very rare cases, the mechanical pressure on the chest from a mammogram or an ultrasound may cause a tear in the breast implant

Researchers suggest that the rupture of a silicone or saline breast implant is a multifactorial process. This means that a breast implant doesn’t rupture easily – you may experience more than one of the mentioned causes combined before your implant tears or leaks.

For example, your implant could become worn out with time but still doesn’t rupture until it receives a blow from an accident or another blunt force trauma to the chest.

What Are the Symptoms Of a Ruptured Breast Implant?

What happens when an implant ruptures? And how can you tell if you have a ruptured implant?

The symptoms of breast implant rupture depend on whether you have a silicone-filled breast implant or a saline-filled breast implant.

In general, you should suspect a ruptured implant if you experience one of the following symptoms:

  • Changes in the size or shape of your breasts
  • Pain, firmness, or swelling in the breast
  • A visible breast deformity
  • A tingling sensation in the breast
  • Changes in nipple sensitivity
  • Capsular contracture (a hard and dense capsule around the implant)
  • Breast granulomas (small areas of inflammation in the breast)

However, the rupture of a saline implant is different from the rupture of a silicone implant.

Silicone vs saline implant rupture

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Saline breast implants are usually inserted empty into the chest through a small incision. After they’re in place, the implant will be filled with sterile salt water (saline).

When a saline implant ruptures, the saline water inside of it will leak out causing the implant to shrink and collapse. Consequently, you might want to consider that your saline implant has ruptured in case you notice the following:

  • A distorted breast appearance
  • Loss of fullness in the upper pole of the breast
  • An abnormal breast shape
  • Visible rippling or apparent implant edges

Even though a ruptured saline implant can affect the shape of your breast, it doesn’t usually cause any health concerns – the leaking saline is just sterile water that will be naturally absorbed by your body.

On the other hand, unlike a saline implant, when a silicone implant ruptures, it doesn’t collapse and usually doesn’t change the shape or size of your breast. Instead, the silicone remains stuck inside a layer that forms around the implant.

A ruptured silicone implant that doesn’t cause any problems and remains undetected for a long time is known as a “silent rupture”. You may not know you have a silent implant rupture until you get an ultrasound or an MRI (magnetic resonance imaging) for your breasts.

You may suspect that your silicone implant has ruptured in case you experience the following symptoms:

  • Breast pain
  • Breast thickening
  • Lumps in or around the breast
  • Changes in the contour or shape of the breast

You can make sure that your silicone gel implant is still in good condition by getting an MRI 3 years after your breast surgery and once every 2 years after that.

During your follow-up with Dr Hunt, he will give your breasts a thorough examination to make sure that all is well with your implants and that everything is in place.

How Common Is Implant Rupture?

Ruptured breast implants aren’t that common – implant rupture rates are very low, especially in the early years after you get your implants. As the implant ages, it becomes somehow more likely to rupture, but not by much.

Breast implants have been used for several decades. During this time, their safety and efficiency have been heavily investigated.

Over the years, implant manufacturers have made significant changes in the design of implants to make them stronger, safer, and more durable.

The third generation of implants with multilayered shells is now available and has significantly reduced the risk of rupture. Modern implants can last up to 35 years and remain intact without rupturing. Nevertheless, a revision surgery is usually needed after 10-15 years to address the breasts and erase some of the signs of ageing – even if the implants are still intact.

The rupture rates of an implant depend on:

  • The manufacturer of the implant
  • The shape of the implant
  • The age of the implant
  • The implant filling (silicone or saline)
  • Type of breast surgery (primary augmentation mammoplasty, revision augmentation, primary reconstruction, revision reconstruction)

These are all factors that can affect how easily an implant ruptures. In general, implants are hard to rupture even as the implant ages.

Long-term data from one implant manufacturer showed that 8 years after a breast augmentation mammoplasty, implant ruptures occurred in less than 6.5% of the patients. Even 10 years after breast surgery, less than 10% of the patients had ruptured implants.

Moreover, 98% of patients who received more modern implants were rupture-free 5 years after receiving the breast implant. Even after 10 years, around 85% of those patients were still implant rupture-free.

Dr Jeremy Hunt uses breast implants like the Motiva breast implants or Mentor breast implants.

How Is the Implant Rupture Treated?

Although a ruptured breast implant usually doesn’t pose any health risks, you’ll probably need surgery to remove the ruptured implant.

Whether it’s saline or a silicone implant, Dr Hunt will surgically remove the damaged implant. If you’d like, he can also replace it with a new one during the same surgery.

In case you have a silicone implant that has ruptured but isn’t bothering you or causing you any trouble, you may be able to keep it in. A silent rupture will not change the shape of your breast and wouldn’t cause you any health problems.

Therefore, you can discuss with Dr Hunt whether you want to remove the ruptured silicone implant, replace it, or keep it in place.

What Are The Complications Of Implant Rupture?

A lot of research has been dedicated to the complications following the rupture of a breast implant.

So far, studies found no link between breast implant rupture and any health concerns. According to research so far, a ruptured breast implant:

  • Will NOT increase your risk of breast cancer
  • Will NOT cause any connective tissue or autoimmune disease (such as rheumatoid arthritis)

Most implant ruptures pose no health risks and a lot of them are undetectable. One known complication of a ruptured breast implant is capsular contracture– a condition where the tissue around the implant hardens and tightens.

What To Do When You Suspect a Ruptured Breast Implant?

If you think your implant is leaking or that you may have a ruptured implant, contact your plastic surgeon immediately.

By performing a physical examination, ultrasound, or MRI, Dr Hunt will be able to determine whether your implant is damaged or intact.

Your implant can be surgically removed (explanted) and replaced with a new one. In case of the silent rupture of a silicone implant, you might not need surgery at all. Dr Hunt will recommend that you keep an eye on any changes or discomfort in your breast to make sure the implant won’t cause you any trouble.

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FAQs about Implant Rupture

Does insurance cover a ruptured implant?

  • Most insurance companies only cover medically necessary cosmetic procedures. Therefore, you may be covered if your breast implant ruptures and causes infections, chronic breast pain, severe corpuscular contracture, or other health concerns.

Does a ruptured implant need to be removed?

  • A ruptured breast implant is usually removed if it’s causing breast deformities, physical discomfort, or health problems. A ruptured saline breast implant usually causes an irregular breast shape and requires surgical removal. Alternatively, a ruptured silicone implant doesn’t usually change the shape of the breast and can be left in if it isn’t causing any other discomfort.

Is a leaking breast implant an emergency?

  • The rupture of a breast implant is not a medical emergency. Nonetheless, you must replace your ruptured breast implant as soon as you can to fix the shape of your breast and avoid possible capsular contracture (internal scar tissue formation).

How long can you leave a ruptured implant?

  • Theoretically, you can leave a ruptured breast implant in as long as you’d like if it’s not causing you any pain or discomfort. The deflated or torn implant shell will not affect your health. However, the longer the damaged implant stays in, the more difficult its removal will be later on. Most patients prefer to remove and replace their implants as soon as possible after the rupture to restore the cosmetically appealing appearance of their breasts.

What do ruptured implants look like?

  • The signs of a leaking saline implant include breast ripples, visible implant edges, and deflated breasts. If one of your saline implants ruptures, you might notice that one of your breasts is starting to look smaller or remarkably different than your other breast. On the other hand, in some cases, a ruptured silicone breast implant can cause noticeable lumps or thickening in or around the breast. In other cases, it might not cause any physical changes to the breast.

Can a ruptured implant make you sick?

  • Different studies have found no link or connection between a ruptured breast implant and any health problems. There have been some reports of symptoms experienced by women after their implant rupture. Nonetheless, there has been no scientific evidence to support or prove that those symptoms were caused by implant rupture.

Further Reading about Breast Procedures

Medical References

About Dr Jeremy Hunt – Specialist Plastic Surgeon

Dr Jeremy Hunt

Dr Jeremy Hunt is a specialist plastic surgeon performing breast, body, face and nose surgery in Australia. He is a member of FRACS & ASPS and has over 20 years of experience providing cosmetic and plastic surgery in Sydney.

Dr Hunt’s personal, one-on-one service and attention to detail has ensured that thousands of women and men from the Sydney & Wollongong NSW area and across Australia have received high quality surgical care.

Dr Hunt’s qualifications and education

Dr Jeremy A Hunt MBBS FRACS graduated with a Bachelor of Medicine degree from Sydney University in 1990 and is a Fellow of the Royal Australasian College of Surgeons and member of ASPS – the Australian Society of Plastic Surgeons. He completed a Fellowship at the prestigious University of Texas in the United States, where he learnt from some of the world’s very best plastic surgeons.

Next Step – Make an Enquiry or Request a consultation with Dr Hunt

Want more information before scheduling your consultation?

Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health professional.