Types of Breast Lift Scars · Los Angeles
Types of Mastopexy Scars Treated at Kare Plastic Surgery
The type and location of a breast lift scar depends on the technique used during the original procedure. Each scar pattern requires a specific approach to revision.
Periareolar (Donut) Scar
A circular scar surrounding the areola following a circumareolar or donut mastopexy. This scar is prone to spreading and widening because the natural tissue tension around the areola pulls the scar outward during healing. Wide periareolar scars are one of the most common reasons patients seek scar revision after breast lift surgery.
Vertical (Lollipop) Scar
A scar running from the bottom of the areola down to the breast fold following a vertical or lollipop mastopexy. The vertical portion of this scar can become raised or widened, particularly in the lower segment near the breast fold where tension is highest during healing.
Anchor (Wise Pattern) Scar
The most extensive scar pattern, consisting of a periareolar scar, a vertical scar from the areola to the fold, and a horizontal scar running along the inframammary fold. The inframammary fold portion of the anchor scar is well hidden in the breast crease but can develop hypertrophic or keloid changes in susceptible patients.
Inframammary Fold Scar
The horizontal scar along the underside of the breast that results from anchor and some lollipop mastopexy techniques. While this scar is typically hidden within the breast fold, patients with tight bra lines or who spend time in swimwear may find it visible and wish to have it improved.
Why Some Breast Lift Scars Look Worse Than Others
Not all patients who undergo the same breast lift procedure develop the same scars. Several factors determine whether a breast lift scar heals smoothly or becomes a problem that warrants revision.
Genetic Predisposition
Patients with a personal or family history of raised scars, keloids, or slow scar fading are at higher risk of developing problematic breast lift scars. Those of African, Asian, Hispanic, and Mediterranean descent are more prone to hypertrophic and keloid scarring, which can be more persistent and more noticeable after breast surgery.
Wound Tension
The amount of tension placed on the skin edges during closure has a major effect on the final scar. High-tension closures, particularly in larger breast lifts that remove significant skin, produce wider and more visible scars. Dr. Karamanoukian uses layered deep suture techniques during breast lift surgery to minimize surface tension and improve the final scar quality.
Healing Complications
Wound separation, infection, or fluid collection during the healing period after breast lift surgery disrupts the normal scar maturation process and tends to produce wider, thicker, and more discolored scars. Patients who experienced any healing complications after their original surgery are more likely to benefit from active scar management.
Smoking and Nutrition
Smoking significantly impairs wound healing by reducing oxygen delivery to the healing tissue, which leads to wider and less favorable scars. Nutritional deficiencies during the healing period also affect collagen production quality and the speed of scar maturation. Patients are advised to stop smoking well before any scar revision procedure at Kare Plastic Surgery.
Sun Exposure
Unprotected sun exposure during the first year after breast lift surgery causes permanent darkening of the healing scar. Pigmentation changes from sun exposure can persist long after the scar has otherwise matured and are among the more difficult scar qualities to address. Daily sunscreen application to healing breast scars is essential in the first year after surgery.
Inadequate Postoperative Care
Starting scar care early after breast lift surgery, including silicone sheets, massage, and sun protection, significantly improves the final scar appearance for most patients. Patients who did not receive guidance on scar care after their original surgery or who did not follow recommendations often present with more noticeable scars that respond well to the active treatment options available at Kare Plastic Surgery.
Kare Plastic Surgery · Santa Monica, Los Angeles
Schedule Your Breast Lift Scar Revision Consultation with Dr. Karamanoukian
How Dr. Karamanoukian Treats Breast Lift Scars
The right treatment for a breast lift scar depends on the character of the scar, how long it has been present, and how it is affecting the patient. Dr. Karamanoukian evaluates each scar individually and recommends a treatment plan that addresses the specific features of that scar, rather than applying a single approach to every patient.
Laser Resurfacing and Pulsed Dye Laser
Laser treatment is the most commonly used first-line option for breast lift scars that are red, raised, or have uneven texture. Pulsed dye laser targets the blood vessels that give hypertrophic scars their reddish color, causing them to shrink and fade over a series of sessions. Fractional laser resurfacing addresses surface texture and irregular thickness, smoothing the scar profile. Laser treatments can be started as early as 6 to 8 weeks after surgery to positively influence early scar formation, and are equally effective on mature scars that are years old. Dr. Karamanoukian selects the appropriate laser based on the scar type and the patient's skin tone.
Steroid Injections
Intralesional triamcinolone injections are a cornerstone of treatment for raised or thickened breast lift scars. Injected directly into the scar, corticosteroids suppress the fibroblast activity that drives collagen overproduction and reduce the inflammatory response that keeps scars red and firm. A series of injections spaced four to six weeks apart typically produces significant flattening and softening of hypertrophic breast lift scars. Steroid injections are often combined with laser treatment for an additive effect, particularly in scars that are both raised and red.
Surgical Scar Excision and Re-closure
Wide or significantly thickened breast lift scars that do not respond adequately to non-surgical treatment can be surgically re-excised and re-closed with improved technique. For periareolar scars that have spread, re-excision with placement of a permanent periareolar suture helps prevent the scar from widening again after revision. For anchor and lollipop scars, the revision incision is planned to minimize tension on the closure, using deep sutures to support the skin edges. Surgical revision is typically reserved for scars that have fully matured, generally at least 12 months after the original breast lift.
Silicone Sheets and Gel
Medical grade silicone sheets worn over the breast lift scar have strong evidence of effectiveness for both preventing problematic scars and improving existing ones. Silicone maintains moisture over the scar surface and reduces the inflammatory activity that causes collagen overgrowth. Silicone gel is an alternative for areas where sheets are difficult to apply, such as the periareolar region. Dr. Karamanoukian recommends silicone therapy as a daily home treatment that patients use alongside in-office procedures for the best combined result.
Keloid Treatment for Breast Lift Scars
Patients who develop true keloid scars after breast lift surgery require a more aggressive combination approach. Surgical excision alone for keloids carries a very high recurrence rate, so Dr. Karamanoukian pairs excision with postoperative steroid injections, silicone therapy, and in some cases radiation therapy to reduce the risk of the keloid returning. His experience as a nationally recognized keloid specialist makes Kare Plastic Surgery a trusted referral for breast keloid patients who have not responded to prior treatment. Call (310) 998-5533.
Pigmentation Treatment
Darkened breast lift scars from post-inflammatory hyperpigmentation or sun exposure are treated with protocols tailored to the patient's skin tone. Options include medical grade topical agents, chemical peels, and laser treatments that target melanin in the scar without damaging surrounding skin. Dr. Karamanoukian chooses pigmentation treatment protocols that are safe for all skin tones, which is especially important in patients of color who are at higher risk of further pigmentation changes from aggressive treatment.
When is the right time to treat a breast lift scar? Non-surgical treatments like laser and steroid injections can begin as early as 6 to 8 weeks after breast lift surgery to guide early scar formation. Surgical scar revision is generally deferred until at least 12 months after the original procedure, once the scar has fully matured. Patients who present years after their original surgery can still benefit significantly from scar revision. Dr. Karamanoukian evaluates each scar regardless of how long it has been present. Call (310) 998-5533 for a same-week consultation at Kare Plastic Surgery, Los Angeles.
"A breast lift scar that does not heal well is not something a patient should have to live with indefinitely. "
— Dr. Raffy Karamanoukian · Board-Certified Plastic Surgeon · Kare Plastic Surgery, Los Angeles
Frequently Asked Questions
What causes breast lift scars to look bad?
Breast lift scars can become wide, raised, red, or pigmented due to wound healing tension, genetic predisposition to hypertrophic or keloid scarring, infection during healing, premature sun exposure, smoking, poor nutritional status during recovery, and inadequate postoperative scar care. The periareolar scar and the inframammary fold scar are the most common sites of problematic scarring after mastopexy. Dr. Raffy Karamanoukian at Kare Plastic Surgery in Los Angeles evaluates and treats all types of breast lift scars. Call (310) 998-5533.
How long should I wait before having breast lift scar revision?
Most surgeons recommend waiting at least 12 months after breast lift surgery before pursuing formal scar revision, since scars continue to mature and improve on their own during this period. Laser treatments and steroid injections can be started earlier, typically at 6 to 8 weeks after surgery, to help guide the scar toward a better outcome before it fully matures. Dr. Karamanoukian at Kare Plastic Surgery evaluates each scar individually and advises on the most appropriate timing for each treatment. Call (310) 998-5533.
Can periareolar breast lift scars be revised?
Wide or raised periareolar scars following circumareolar or donut mastopexy are among the most common breast lift scars that benefit from revision. Dr. Karamanoukian uses surgical re-excision with precise tension-free closure, laser resurfacing, and steroid injections to improve periareolar scars. Pursestring closure techniques and permanent periareolar sutures may be used to prevent scar spreading during re-excision. Call (310) 998-5533 at Kare Plastic Surgery in Los Angeles.
What treatments are available for breast lift keloid scars?
Breast lift keloid scars are treated with a combination approach that includes surgical excision, intralesional steroid injections, laser therapy, silicone sheeting, and in some cases postoperative radiation therapy. Surgery alone for keloids carries a high recurrence rate, which is why Dr. Karamanoukian at Kare Plastic Surgery combines excision with adjuvant treatments to achieve the most durable improvement. Call (310) 998-5533.
Is breast lift scar revision covered by insurance?
Breast lift scar revision is generally considered a cosmetic procedure and is not covered by insurance unless the scar is causing a functional problem such as pain, restricted movement, or chronic skin breakdown. Dr. Karamanoukian's team can provide a letter of medical necessity for review in appropriate cases. Call (310) 998-5533 for more information.
Schedule Your Breast Lift Scar Revision Consultation