Q: Dr. Eppley, I had breast lift surgery about seven weeks ago. They were fine until three weeks after surgery when the bottom part of my incision opened up to about the size of a quarter. It has now finally healed but the healed areas are very sensitive and it hurts to touch. I can’t wear any type of bra and as light as shirts are, I can’t stand it touching it, I lay down and sleep at night but when when I roll over it rubs against the mattress and wakes me up throbbing. I have attached a few pictures for you to see. Is there anything I can do to be able to wear clothes?
A: Based on your pictures it looks like your breast lift wounds have nearly healed and now you just some sensitive scar formation over the wounds, which is very typical at this point in the healing. That sensitivity of the scars will decrease over time but the question is what you can do now. They would be best treated by either silicone topical gel or silicone scar sheets, both of which are available over the counter in a drugstore. Either way you need to keep them covered so they don’t get rubbed on which is obviously uncomfortable due to the scar’s sensitivity. As the scars settle down and mature more this sensitivity will go away. The silicone sheeting can be particularly helpful in providing both coverage of them and expediting the scar maturation process.
Dr. Barry Eppley
Q: Dr. Eppley, I have 38 DD breasts which sit on my stomach with the nipples pointing downward. I want them lifted back up but am afraid of the scars of a breast lift. I have seen some pictures and videos of the surgery and, quite frankly, it scares the hell out of me. I don’t want ugly scars on my breasts. What type of breast lift is available that does not leave any scars?
A: Breast lift surgery is about moving the nipples up to a more central position on the breast mound and reshaping the breast mound so that it sits back upon the chest wall. This is done by a geometric rearrangement of the breast skin that involves a fair amount of breast skin removal. This where the typical inverted-T or anchor scar pattern comes from in a full breast lift procedure. While there are several more limited breast lift operations that involve less scarring, the amount of lifting and breast shape and position change is also a lot less. In short, there is no type of breast lift that does not involve scars. With the amount of breast sagging that you have, only a full breast lift will do any good. If the scars you have seen from breast lift surgery look worse than the sagging that you now have, then such surgery is not a good choice for you. Satisfaction after breast lift surgery is about feeling that the scars, undesireable that they may be, are a better problem than sagging unscarred breasts.
Dr. Barry Eppley
Q : I would like perky and fuller breasts. I have had three children and my breasts have just lost everything. They are so saggy and droopy they are disgusting. I am so embarrassed about them I won’t even let my husband see them. My right breast is also different than the left. It is bigger and more saggy and the nipple is much bigger. I know I want implants but I think I may some sort of lift too. Can you tell me how bad the scars will be?
A: The need for a lift with the use of breast implants can be determined by one simple anatomic measurement…where does the nipple sit relative to the lower breast fold. (inframammary crease) If the nipple is above this level, an implant alone will give the breast a good shape with the nipple reasonably centered on the new larger mound. If the nipple sits at or below the fold, then an implant will make the breast bigger but the nipple will be on the ‘southside’ of the mound. (i.e., pointing downward)
There are essentially four types of breast lifts based on how much the nipple needs to move upward. They are with their resultant scars; type 1 superior nipple lift (scar on top part of nipple), type 2 circumareolar lift (scar 360 degrees around the nipple), type 3 vertical breast lift (scar around the nipple and vertically down to the fold) and type 4 full breast lift. (around the nipple and vertically down into the fold and then horizontally along the fold, an anchor scar pattern)
In general, breast lift scars usually turn out pretty well. The scars around the nipple and along the inframammary fold do the best. If a vertical breast scar is needed between the nipple and the fold, this is the one that has the most potential to widen due to the constant pulling by the weight of the breast against the scar. Most breast lift scars revisions involve that scar if needed.
Dr. Barry Eppley