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  The one thing that is guaranteed with breast augmentation is that you will get a scar where the skin is
cut and implant inserted. Depending on the incision site chosen (and your own healing process) your
scar may fade to be smooth, flat and almost invisible. But there are some patients that end up with
visible and unattractive scars.

  The location of the incision site is an important decision that should be decided with your surgeon as
different patients are better candidates for a certain incision location. For example, if a patient has a
well-developed fold, then the crease incision can be very nicely hidden. Alternatively, if the patient has
a large and darkly pigmented areola, then the areolar approach may be best for hiding the incision.
For patients with minimal or no sagging, absence of a well-developed fold and a smaller areola, the
armpit incision may be best.

  There are various reasons a patient may end up with a problem scar after breast augmentation
surgery. A persons medical history or some medical conditions may contribute to problem scarring.
Other factors could be skin colour, improper cleaning or infection of the incision, injury to the incision
site while healing, exposure to sunlight, poor nutrition and age.

  There are a few options available for those wanting to approve the appearance of their breast
augmentation scar and your plastic surgeon may recommend one of the following treatments:

Vitamin E: Some surgeons suggests a patient rub Vitamin E oil on their incision site once it has closed.
Some think it improves the appearance of the scar, others think it just keeps the scar moisturized but
nothing more.

Silicone Sheeting: The most recognized product for reducing redness and flattening a scar is a silicone
based product. Silicone sheeting is a product you can buy at your surgeons office or you may be
referred to a hospital. It comes in a strip that you cut into pieces and stick onto your scar. These
pieces need to be replaced every 10 days or so.

Silicone Gel: You can also buy a silicone product in a gel form. The gel has similar properties as
silicone sheeting but dries in a thin layer acting like an extra layer of skin.

  If a scar does not respond to the above treatments there are some other procedures such as scar
revision, cortisone injections or laser treatment available. Your plastic surgeon would be able to
suggest the right action for you to take.

Why do scars form?
When the skin is damaged the body responds in three phases; inflammation, rebuilding and
remodelling. The immune system responds immediately to fight off infection. The body produces
inflammation to fight against infection. Inflammation causes an increase in the local blood supply so
that large numbers of white blood cells can be brought to the damaged area to fight infection. During
the rebuilding phase, the skin begins to repair the damage to help heal the wound so that it may close.
Collagen fibres are produced during the repair process. Finally, in the remodelling phase, more
collagen fibres are produced and organized to increase the strength of the skin. Often, the immune
system overreacts with more white cells and collagen than necessary, causing excessive scarring that
is red, raised and unattractive. A scar looks different from normal skin because fibres are organized
differently than in normal skin. The resulting scar is genetically determined. Scarring can be worse in
certain races (heavily pigmented skin), certain areas (chest, shoulders, upper back, jaw line), at certain
ages (younger) and if placed across lines of skin tension.

What is a keloid scar?
A keloid is an overgrowth of scar tissue at the site of a skin wound. The new tissue is elevated,
rounded, and firm, with irregular and claw-like margins. Keloids occur most often in heavily pigmented
people and tend to get progressively worse.

What is a hypertrophic scar?
A hypertrophic scar is a wound that heals to greater than normal size as a result of an aggressive lay
down of collagen, contained in larger than normal skin cells, producing a raised, smooth,
hyperpigmented result. The site maintains a higher than normal level of sensitivity and the tissue is
more fibrous in structure.