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How to prevent hypertrophic scar

I am looking into getting breast augmentation. I have a history of hypertrophic scars. My first cesarean left me with a Hypertrophic scar. During my second cesarean my obstetrician removed to raised scar and used individual stiches that were removed earlier then normal (5days) and lots of steristrips applied. This time I never got a raised scar and healed perfectly. So my question is : Where is the best place for incision and what stich style appropriate to prevent hypertrophic scars in a breast augmentation?

funsun September 7th, 2016 QLD

  • Answer
    Dr. Raymond Goh

    Raymond Goh

    123 answers

    Plastic Surgeon
    Queensland, Australia

    Hi there Funsun.
    Scarring post any elective surgical procedure is determined in general by two categories of factors:1. Patient factors: genetic predisposition to adverse scarring (keloid or hypertrophic). This is often related to racial predisposition to adverse scarring. Other patient factors include smoking and general healing ability.2. Surgical factors: these include tissue handling and the way the wound was closed and supported. 
    If a patient was prone to adverse scarring, then all measures to prevent this from occurring are employed. These can include but not limited to: internal sutures to take the tension away from the skin surface, skin taping for additional support, and topical creams and gels. Despite all measures, some patients will still have a scar that is less than ideal. You do however need to give scars time to mature and fade. 
    The location of the incision (inframammary crease, around the nipple areola, or in the axilla) should not determine whether you are going to get a better scar or not. 
    I hope this is of help. 
    All the very best.
    Dr Ray GohValley Plastic Surgery