Re-occuring scar tissue

[Fisher]

I had direct excision almost 11 months ago and had scar tissue occur on both sides. Both sides have been treated twice with a diluted steroid that definitely brought the tissue down over time.  But, after 3 months of the first shot, the scar tissue became inflamed again. The second shot was given, and the scar went down to dime size again. Now a few months later, the scar tissue is increasing again. 

Is this normal for scars to re-occur? I know it isn't gland because the scar goes almost completely away each time a shot is received. Does this sometimes take multiple rounds? 

I ask because my surgeon said he'll only do 2 rounds, so I might have to look elsewhere. Or do these flare up sometimes occur then resolve on their own? 

Thanks in Advance

[Dr. Elliot Jacobs]

I treat scar tissue with Kenalog injections -- they work and are usually permanent.  That is, the scar tissue does not return.

I have never had a patient in which successfull treatment with Kenalog was followed by recurrent growth of scar tissue.  Perhaps you should return to your surgeon to discuss the situation and specifically what he did during the surgery.  For example, did he leave any residual gland to support the nipples?  If so, perhaps there is gland re-growth.

Sorry I can't be more re-assuring.

Dr Jacobs

[DrPensler]

I often inject kenalog for scar formation. The results are a bit variable. It often requires multiple injections and the injections are separated by a couple of months in general. There is a science and an art of medicine. We know what occurs on the cellular level ( science ) but the exact timing and the amount to inject is more in the art realm and in my experience needs to be individualized for each patient.

[Dr. Schuster]

It is not uncommon to have a little scar tissue to develop somewhere near the nipple. This usually responds very well with steroid injections which sometimes can be repeated as many times as it takes, not closer than 6-8 weeks between treatments. 

[Dr. Robert Wilcox]

Dear Fisher,


Gynecomastia surgery is the most common thing i do in my practice and i have found that roughly 20 to 30% of my patients will require steroid injection postoperatively. This simply is an area that likes to develop scar tissue. I typically will inject Kenelog steroid at a concentration of 20mg per ml. It is not unusual to have to inject it a third or fourth time since it is all in a localized area. There is no harm doing more than two rounds. I have done three or four rounds on patients for 10 plus years without ill effect.

I hope this has been helpful.

Sincerely,
Dr. Dr. Wilcox, M.D.

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