Mastectomy scar revision

About the procedure

After a women has a mastectomy, the appearance of the chest is fundamentally changed. If there is no breast reconstruction, the chest is flat and doesn't look anything like the other side. The flat part of the mastectomy scar may be tight and uncomfortable, especially after radiation, and the upper and lower mastectomy flaps sometimes don’t line up with each other. In addition, there often seems to be left over skin that is bunched up in the armpit. This extra skin can be tender and painful, and never seems to fit well into a bra, which can make it hard for women to find clothes that fit. In addition to the mastectomy skin flaps being misshapen and uncomfortable, the mastectomy scar itself can occasionally be hypertrophic (raised) and hyperpigmented (dark). During the revision of the mastectomy skin flaps, Dr. Hirsch will also revise the scar so that it is more aesthetically appearing as well!

Mastectomy scar revision is a procedure for Los Angeles women who are experiencing these problems after a mastectomy, or who just want their mastectomy scars to be improved. Dr. Hirsch tailors his approach so that his treatment meets the needs of each patient. The actual plastic surgery techniques that Dr. Hirsch uses to perform mastectomy include removing excess skin and fat directly, and also using liposuction to correct contour abnormalities. After surgery, the extra skin on the chest and in the armpit is smoothed out, and it is more comfortable for women to wear clothes. Occasionally, breast reconstruction is an option for women who wish to improve the appearance of their mastectomy scars as well.

Mastectomy scar revision is usually an outpatient procedure so that patients can go home on the same day as surgery. Usually, there isn't very much pain or bruising/swelling. If the mastectomy skin flaps need significant revision, then it may be necessary to use a drain after surgery for a few days until the drainage is low enough that the drain can safely be removed in the office. Most patients are able to return to work within one week following mastectomy scar revision. Dr. Hirsch will usually wrap your chest in an ACE bandage or other compressive garment. You should keep this in place at all times except when you shower, unless you are instructed to do something different by Dr. Hirsch.

Frequently asked questions about mastectomy scar revision:

Is mastectomy scar revision covered by insurance?

Most major insurance companies will cover mastectomy scar revision. Dr. Hirsch and his team will work with your insurance company to confirm that your mastectomy scar revision surgery will be covered.

I have had radiation, am I a candidate for mastectomy scar revision?

Yes, even though you have had radiation, you may still undergo mastectomy scar revision. However, it is important to understand that radiation therapy for breast cancer causes permanent changes to the skin of your breasts, and you may be at risk for wound healing problems after surgery.

Will I have drains after mastectomy scar revision?

In most cases, you will not need drains after mastectomy scar revision but occasionally it will be necessary to use a drain. If a drain is used, it is very important to keep track of the amount of fluid that comes out so that Dr. Hirsch will know when the drain is able to be removed. Dr. Hirsch’s office staff in Encino or Burbank will give you a sheet that you can use to keep track of the drain fluid. You may also be given a prescription for antibiotics that you will need to take as long as the drain are present. When the drainage is low enough, Dr. Hirsch will remove the drain in the office.

When can I start exercising again after mastectomy scar revision?

Depending on what type of surgery was performed, you may be able to start light exercise within the first week or so following your mastectomy scar revision.  Dr. Hirsch will let you know when it is safe to resume your normal exercise routine.

When can I go back to work after mastectomy scar revision?

The amount of time off work following a mastectomy scar revision really depends on the type of work that you do and what procedure was performed.  If surgery was more extensive and your job requires heavy physical activity, you might need to be off work for 1-2 weeks.  Otherwise, you should be able to return to work after 1 week.

When can I shower after mastectomy scar revision?

You can shower the next night after mastectomy scar revision. It is ok to use soap and water on your skin and the incisions on your chest and you may shampoo your hair like you normally would.  You don't need to scrub your incisions, just let soap and water run over them and pat them dry.

As a plastic surgeon in the Los Angeles area, Dr. Hirsch also specializes in breast augmentation, breast reduction, breast implant revision, skin care, and body contouring.