In most cases, male breast reduction scars are limited around the border of the areola complex, which is the pigmented part of skin. As the patients move forward to their recovery, the “surgical marks” gradually fade until they become imperceptible.
With the use of incisions around the areola’s border (bottom half), doctors are able to remove the excess skin, breast tissue, and fat. However, some patients will need liposuction as well for an additional amount of contouring.
Liposuction scars—which are usually 2.5-inch diameter or less—are also discreetly positioned within the border of the areola or very close to the armpit, so they are hard to detect even by the patients themselves.
Another common technique is to place a ¼ inch incision inside the armpit, allowing the surgeons to remove the excess tissue and fat. While the resulting scars are virtually undetectable, the approach is not enough for patients who have a significant amount of redundant skin.
Aside from discrete scar placement, it is also crucial to eliminate unnecessary tension on the skin surface to prevent the scars from stretching or becoming irregular. This is often done through proper wound closure and use of dissolvable internal sutures, which can also support the new contour.
To further promote favorable scarring, some doctors recommend the use of scar creams and/or silicone tapes at least three weeks postop. Others suggest massaging the incision site (clinically healed) in an attempt to break up the scar tissue while it still responds well to such manipulation.
All scar treatments must only start after the wound is fully closed and clinically healed to prevent causing harm to the incision site.
Despite all attempts to achieve favorable scars, some patients remain susceptible to keloids. Studies have linked darker complexion to increased risk of aggressive scarring and hyperpigmentation (or darkening of the incision site).
While scar revisions, laser treatments, and camouflage medical tattoo can improve the scars, these should only be done about a year after surgery. The idea is to wait for the scar to settle and mature—i.e., there is no redness and could have shrunk to its best appearance.
Performing the aforementioned treatments too soon could lead to unpredictable results.
It is also helpful to avoid sun exposure or to use sunscreen/protective clothing for at least a year because ultraviolet rays can affect healing and lead to darker scars or hyperpigmentation, explains leading Brea plastic surgery expert Dr. Tarick Smaili.