What can I do to minimize the chances of scarring?

You can’t avoid scarring altogether, but find out what you can do to minimize it.

You get breast enhancement surgery to improve your appearance, so it makes sense that one of the things you’d be most concerned about is scarring — something that can detract from your appearance. In fact, scarring is probably the greatest concern that women considering breast augmentation have. But rest assured, you’re not the only one concerned about scarring: your surgeon will do everything possible to minimize the appearance of scars. In fact, plastic surgeons are specifically trained to close incisions inconspicuously, and they take pride in their ability to do this.

Aside from the skill of the surgeon, there are three other factors: the type of incision you get, the type of skin you have (and its propensity to scar), and how well your scar heals.

The Incision Makes the Scar
Many things will factor into your decision about which incision to get. The surgeon you choose must be skilled and practiced at doing that type of incision, of course. But for many women, their incision choice is heavily influenced by type of scar the incision creates, and more specifically, the placement of the scar.

Periareolar Incision: The incision is made along the areola complex (the darker skin that surrounds your nipple). It’s sometimes called the “smile” incision. Since the incision is along the areola, where the skin is already darker, it produces less conspicuous scars (they tend to blend into the areola). No scars are visible in clothing.

Inframammary Incision: This incision is made in the fold beneath your breast. This scar may be more noticeable because it’s not camouflaged by darker skin. Also, you’ll want to make sure that your breast “folds over” and covers the scar.

Transaxillary Incision: This incision is made through your armpit. Unlike the other incision scars, this is a scar that you can see, even in clothing. For example, if you’re wearing a sleeveless dress or a bathing suit and you lift up your arms, you can see the scar. Also, if you ever need another breast implant surgery, the surgeon probably won’t be able to go back in through this scar (as with the others).

Transumbilical Incision (TUBA): This incision is made directly through your belly button. From a scarring perspective, this is the best. In fact, you likely will have no visible scar. But there are other drawbacks that make it less than ideal (namely, the incision is very far away from where the implants need to be, which increases the chances for not getting the implants perfectly placed). Also, it can cause “tracks” in the shape of a “V” — from your belly button to your breasts. Tracks aren’t the same as a scar, but the look can be equally as undesirable, depending on how noticeable the tracks are. In general the TUBA approach is only done with saline implants.

Post-Op Care
If you’re having a breast lift at the same time as your implants, you’ll want to talk to your doctor about ways to reduce scarring (for some women, the implants can “push against” the incision, which means the incision takes longer to heal — which can increase the risk for scarring).

Whether you’re having one or two surgeries, your post-op care will be critical. Not only do you want to do everything you can to prevent infection for your own health, you also want to speed up the healing process. First, you definitely don’t want to smoke after your surgery, because nicotine constricts blood vessels, which cut down on the oxygen the surgical area gets (the incision needs oxygen to heal). Follow all of your post-surgery instructions to the letter. Also, your surgeon may also recommend homeopathic remedies you can take orally or apply to your skin before and after surgery to help to minimize scarring.

Frequently Asked Questions Reviewed by Dr. Richard Baxter in Seattle, WA. To learn more about Dr. Baxter, please go to www.aboutplasticsurgery.com/doctor-profile/richard-a-baxter-md-facs-227.