4.5 months post op question

[Zifnab]

Hi doctors,
I'm about 4 months post op (excision surgery) and have just a quick question. My areolas have become quite puffy due to scar tissue which i can feel very apparently along the incision line and when stimulated on the surface of the areola.

I recently went back to my surgeon to see if there are options for steroid injections to help with the scarring and he recommended I wait due to there still being quite a significant amount of pain in the areola when I come into physical contact with anything. His advice is i shouldn't consider injections until there is no pain/tenderness when touched as it is still healing.

I'm just wondering if it's normal to still have pain (mainly where the scar tissue is present) when it's already been 4 months since the surgery and do you think there is still a possibility it'll settle without the need of injections.

[Litlriki]

It would be helpful if you posted some photos of your condition, since it may be that your pain is associated with hypertrophic scar formation, which would be helped by a corticosteroid injection.  In that case, waiting for the pain to subside is not necessarily a good idea, since it won't go away until the scar has been managed.  Maturation of the scar might eventually lead to less thickening and puffiness, as well as decreased pain, but this could take a very long time.

[Dr. Schuster]

It is not unusual to have some residual mild pain or scar tissue until 6 months after surgery. In general I will use Kenalog injection beginning at around 6-8 weeks if I feel a discrete lump of scar tissue that I want to help resolve. I will sometimes continue the injections conservatively every 6-8 weeks for 2-4 treatments depending upon the progress. Good luck and be careful.