Question:
What can my surgeon do to minimize scarring after a breast reduction procedure? I am 35 and very interested in getting this done but am worried about embarrassing scar tissue.
Answer:
The skin closure is the most important factor in determining whether you will achieve good thin scars that will fade with time. Most surgeons remove their sutures after 10 days and use absorbable sutures to close their wounds. In breast reduction, the surgery is done backwards in that the incisions are under the breast and thus all of the weight of the breast is pushing down onto the incision. Absorbable sutures are absorbed by inflammation. This reaction to the sutures creates a red hard scar that lasts for a prolonged time and promotes scar tissue formation. Early removal of sutures also allows the wounds and scars to spread. Incisions and thus scars are not at 100% tensile strength until they are 7 weeks old.
I like to use nonreactive, non-absorbable sutures for my breasts reductions. I close my wounds with deep Nylon interrupted sutures and I use a Prolene running subcuticular suture for the skin. I leave the prolene skin suture in place till the patient shows some skin reaction to it which is usually at 6 to 7 weeks following surgery. In this way. the wound has gained most of its tensile strength and will not spread or pull apart. Scars turn white within 4 to 5 months and mature quicker that the standard methods.
