PLanned excision (right) and suture (left)
Outward and downward migration of the scar
The removal of sagging skin and subcutaneous fat at the inner thigh.
With aging, the skin looses its elasticity. The skin will sag under the influence of gravity and forms 2 to 3 unsightly folds that can be smoothened.
Patients should refrain from smoking for 10 days before and after surgery.
This operation can be done in day care and under general or local anesthesia
With time, there is always some downwards migration of the scar
This area is by nature prone to contamination and infection. Washing the area several times a day with antiseptics for about 10 days can prevent this. After that, moisturizing cream can be applied twice a day for 3 months.
Pain is bearable postoperatively and will disappear within days.
Complications short and long term
Bruising of the skin (Ecchymosis)
When blood migrates into the skin, the skin first turns blue after a day or two. Over a period of 10 days it further turns into green and finally yellow before disappearing completely. No ointments should be used to speed up this resorption of blood. They could only add a rash.
Blood collections (Haematoma)
When even more blood accumulates in the virtual spaces between subcutaneous fat and breast tissue, this is called a haematoma. Their natural course is to convert to hard nodules -over a period of weeks- that sometimes can be felt and trouble the patient.
They also disappear very slowly, over the course of months.
A seroma is an accumulation of blood plasma in a pocket between subcutaneous fat and fascia. It can be diagnosed by its fluctuating aspect ( think of water mattress) and by puncturing it, retrieving a clear yellowish and slightly viscous liquid.
Treatment is easy : either it can be evacuated in several sessions or -if painless- it will go away by itself .
A primary infection of the breast due to contamination of the tissues during surgery is extremely rare. I never saw one case. A secondary infection can of course occur after necrosis, because of inadequate antiseptical treatment of exposed tissues.
Hypertrophic and Keloidal scars
Breast scars normally heal well except in darker skinned patients, where the risk for keloidal scar is always present. You can find the difference between hypertrophic and keloidal scars and their treatment here
A scar can get broader because of :
In normal but broad scar, a surgical revision of the scar can be done after 6 months. Infiltrations with depot cortisone can also help