Scar Revision

Q: Dr. Eppley, I have attached two photos for your assessment for scar revision surgery. The scar is slanted towards the left at the top and slopes downwards towards the right. The scar healed flat at the top 2 inches and bottom 3 – 4 inches. It’s the section in the middle that healed wider and is slightly raised. Aside from silicone scar sheets and micro needling, I haven’t tried anything else to alter the scar. What I would like to achieve would be a flatter, less bumpy scar.
**I understand that area is prone to scarring badly, so I’m unsure if it is best to leave well enough alone. 

A: Thank you for sending your scar pictures for possible start revision surgery. As midline chest and upper abdominal scars go, this is just typical scar widening that commonly occurs in this area. It is not a hypertrophic or keloid scar which is good. The only effective treatment would be to cut out the scars and reclose it in a finer line…and hope that it heals better this time. At this point treatments such as scar sheets and gels and microneedling are completely ineffective in an established scar like yours. The reason the  middle part of the scar is the most irregular is due to the constant tension from the pull of the breasts. This is a very common adverse scar effect seen in women with larger breasts.

Dr. Barry Eppley
Indianapolis, Indiana