Breast augmentation is a surgical procedure that uses implants to increase the size and shape of the breasts. This process requires the surgeon to create an opening in the skin to insert the implant into a pocket above or beneath the chest muscle. Since this is an invasive procedure, scars are an unavoidable result of placing the implants. Modern surgical techniques focus on placing incisions strategically to make the resulting lines as inconspicuous as possible. The goal is to minimize the scar’s visibility over time through careful placement and diligent aftercare.
Where Incisions Are Placed
The location of the incision is a key decision that impacts the final scar placement, and the surgeon will discuss the options based on the patient’s anatomy and the implant type. The most common approach is the inframammary incision, which is positioned in the fold where the breast meets the chest wall. This location provides the surgeon with direct access to the surgical site, allowing for precise implant placement and often resulting in a scar that is concealed by the natural breast crease or a bra.
Another option is the periareolar incision, which is made along the border between the darker areola and the lighter breast skin. This approach attempts to hide the scar within the color transition of the nipple complex, making it blend into the natural pigmentation. The transaxillary incision places the opening in the armpit, completely avoiding a scar on the breast itself. While this can be a preference for some patients, it requires the surgeon to tunnel to the breast area, which may offer less control over the final implant positioning.
Factors Determining Scar Visibility
The way a scar heals is a complex process influenced by both the surgical technique and individual patient characteristics. The surgeon’s precision in making the incision and the meticulousness of the wound closure, often using layered sutures, play a significant role in minimizing the final scar line. The size of the implant chosen can also affect the surrounding skin tension, which can potentially lead to a wider or more noticeable scar.
A person’s genetic makeup and skin type determine how the body responds to the surgical trauma. Individuals with darker skin tones have a higher risk of developing hyperpigmentation, making the scar appear darker than the surrounding skin. The body’s healing response dictates the type of scar: a normal scar is flat and fades, while a hypertrophic scar is raised and red but stays within the original incision boundary. A keloid scar, a less common outcome, is a thick, raised mass of tissue that grows beyond the original wound edges.
Managing Scars Post-Surgery
Managing the scar begins immediately following the operation with diligent adherence to post-operative instructions. Keeping the incision site clean and dry is essential to prevent infection, which can compromise the final scar appearance. Avoiding activities that place tension on the healing tissues, such as strenuous exercise or heavy lifting, is also crucial during the initial recovery period.
Once the sutures are removed and the skin is fully closed, active scar management can begin, usually a few weeks after surgery. The application of silicone sheeting or silicone-based scar gels is a common protocol, as silicone helps to hydrate the scar and provide gentle pressure to flatten the tissue. Gentle massage of the scar area, as advised by the surgeon, can also help break down and soften scar tissue while increasing circulation. Protecting the healing scar from the sun is highly recommended, as ultraviolet rays can cause permanent darkening of the new tissue. For scars that remain raised or discolored after several months, professional interventions such as steroid injections or laser treatments can be used to improve their texture and color.