Breast reduction surgery requires the surgeon to make incisions into the breasts. These incisions will create scars that should fade over time.

Breast reduction surgery typically requires the use of multiple incisions into the breasts. Each incision will heal and form scars. These will typically reduce in appearance as they heal.

A person can take steps to help promote healing and reduce the appearance of the final scar.

This article reviews breast reduction scars, how to minimize them, what to expect, and more.

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Scars form as a natural healing process following a surgical procedure such as breast reduction or from trauma or other injuries that involve lacerations of the skin.

While it may not be possible to prevent the scars, there are steps a person can take to help prevent the development of raised scars or keloid scars.

The type of incision used for breast reduction can impact the severity and amount of scarring present.

There are two main techniques — shorter-scar technique and larger-scar technique.

Shorter-scar technique

The shorter-scar technique, also known as the lollipop lift or keyhole incision, involves making two cuts. One cut goes around the outside of the areola. The second cut extends from the front of the nipple to the crease of the breast.

Surgeons may recommend this technique for moderate reductions. The technique typically produces moderate scarring.

Larger-scar technique

The larger-scar technique, also known as the anchor incision, is the most common type of incision. It involves three cuts:

  • the first cut goes around the outside of the nipple
  • the second cut goes straight down from the nipple to the crease
  • the third cut goes horizontally along the crease under the breast and hides in the underwire line

Surgeons may recommend this cut if a person requires a major reduction. Though it produces the most noticeable results, it also creates the most scarring.

Surgical incisions typically cause the formation of thin and slightly raised scar tissue. At first, the scar will be slightly raised, and the skin will be discolored.

Once it has healed, the scar will flatten and change color. The American Society of Plastic Surgeons states that it can take almost a year for the scars to completely fade and soften.

Evidence suggests that people with dark skin are more prone to hyperpigmentation and the development of keloids. Hypertrophic scars and keloids are thick, raised scars that can appear months after the surgery.

Hyperpigmentation refers to the discoloration of the skin and the scar will be darker in color than the surrounding skin. It occurs when there is trauma or injury to the skin, which results in the overproduction of melanin in the area of injury.

Hypopigmentation can also occur. This means that the scar will be lighter in color than the surrounding skin. The trauma to the skin damages the melanocytes, meaning that they are unable to regenerate and re-pigment the skin.

Will they be itchy or painful?

Scars can be itchy or painful as they heal. The pain may result from a pulling or tightness as the scar heals. Itchiness is a natural occurrence as the skin heals.

Keloid scars can also feel painful and itchy.

A surgeon will provide instructions on how to care for the wound in the days after surgery and during the recovery process.

After the initial healing process, a person can apply a non-perfumed moisturizer on the scar twice a day and should avoid exposing the scar to the sun.

Although research is limited, a person can also apply topical creams that contain onion extract, vitamin A, and vitamin E.

However, the American Academy of Dermatology Association (AAD) suggests that a person speaks with a dermatologist before using these.

Silicone gel

A person may want to consider using silicone sheets or ointments after the wound has closed. These over-the-counter solutions help to:

  • prevent the formation of a raised scar
  • prevent scars from developing after surgery
  • reduce skin inflammation, swelling, itching, or stiffness

The AAD notes that the silicone gel sheets may be more effective than the ointments.

However, a person will need to wear the gel sheet every day for a long period of time. This can result in side effects, such as a rash. If this occurs, a person should speak with a dermatologist to find an alternative treatment option.

Embrace or pressure dressings

Embrace dressings may also help with reducing the appearance of scar tissue.

Surgeons apply these specialized dressings immediately following the procedure to help tighten the connection between the two sides of the skin. This may help speed up the healing process and reduce noticeable scarring.

A study from 2015 found that this dressing may help reduce the appearance of noticeable scars. However, additional, larger studies are lacking.

Laser treatments

Once the scar tissue has fully healed, a person may be interested in a fractionated laser procedure. This procedure uses small lasers to help reduce the appearance of scar tissue.

Before undergoing laser treatments, the AAD recommends a person has a consultation with a doctor. They also note that:

  • it will not fully remove scars
  • additional lifestyle changes may be necessary beforehand
  • insurance may not cover the costs of the procedure

Other options

Other potential treatment options include:

  • Cryosurgery: This involves freezing the scar to destroy the scar tissue.
  • Scar surgery: A surgeon can cut out the scar. However, there is a chance of the scar returning.
  • Corticosteroid or 5-FU injections: These can help to treat raised scars and keloid scars. A dermatologist will inject the medications directly into the scar. It can also help to reduce pain and itching.
  • Polyurethane dressing: This is a moist, flexible pad that a person can wear for 6 weeks after surgery to help prevent raised scars. It is also possible to wear this underneath an embrace dressing.

A tattoo artist may be able to tattoo over the scar tissue or incorporate it into the tattoo design.

However, due to the complexity or challenges of working with scar tissue, a person should consider asking the artist if they have experience working with scar tissue first.

Before getting a tattoo over the scar, a person should wait until it has fully healed. If a person is not sure, they should speak with a doctor and get approval before getting the tattoo.

People can use the following tools to find a plastic surgeon:

If people are concerned about scarring after breast reduction surgery, they should speak with the surgeon during the consultations.

Finding culturally sensitive plastic surgeons

People of Color have a higher chance of hyperpigmentation, hypopigmentation, and keloid scars. So, they may wish to find a highly-qualified surgeon who has experience performing surgery on people with dark skin.

The surgeon should be able to explain their knowledge about how dark skin heals. People may also find it beneficial to ask the surgeon to see before and after photos to see how the scars look.

People can use the following tools to find culturally sensitive surgeons and doctors:

Breast reduction surgery will leave scarring on the breasts. The extent of the scarring will depend on several factors, including the person’s skin and the type of incision a surgeon makes.

A person can take steps to reduce the appearance of scarring, such as using lotions and wearing sunscreen. However, they will not be able to completely remove the scars.

Over time, the scars should become less noticeable and fade.