Kenalog Shots for Scar Tssue

[dcvet]

I had surgery with Fielding in October for mild/moderate gyn.  Results when amazing on both sides when the bandages came off.  About 4 weeks post op I started to develop some scar tissue below my right nipple which actually extended past the nipple towards my upper chest.  It grew to the point of where it was about 50% the size of what the original gyn was and peaked in size about 3 - 3.5 months post op.

In January I had a follow up where the PS confimed that it was scar tissue and scheduled me in for Kenalog shots.  Shortly after the scar tissue appeared to start slowly reducing in size.  I considered cancelling the Kenalog shots, but as I got closer to the app, I decided that I would go ahead and get the shots -I would like to get this fixed up asap

So I got the shots at St.Joseph's last Thursday by Fielding - exactly 40 mg injected directly into the scar.  Immediately after, the scar tissue swelled up to double the size - which wasnt too suprizing since I had a CC of stuff injected in it.  There was no pain at all, and the tissue was swelled up for about 3 days. 

Currently, 6 days later, the scar is about half the size it was before the injection.  PS said it would take at least a few days to see any results, and I may need another shot in two months, but Im pretty sure that the one shot was enough.  If the tissue continues to soften and shrink at this rate, it will be totally gone within a few weeks.

Sweet

[9Wolf]

That's good to hear! ...and that's some good info you gave us there. You wouldn't happen to have any photos of the scarring before or after? Because scarring is one of the hardest things to describe or illustrate when we talk about that here.

[dcvet]

I do have some, but I have no idea what I did with them...  I'll post once I find them

[gynebegone2]

I'm interested in the photos as well, I'm 5 weeks post op and probably have exactly what you have described, its sort of a large frim knot on the upper right part of my nipple extending out toward my armpit.  Anyways I think mine is shrinking a bit.  I saw my PS a few days ago and he said it will soften and that at 16 weeks things will be about as final as they will get.. so I'm crossing my fingers that this thing will soften and my nipple (the top right part is pushed out) and chest will look like it does on the left side.

[rowdy99]

thanks.  that was a helpful story.  i am 9 months and have been dealing with heavy scar tissue and i think i'll try to see if my PS will refer me to get kenalog shots.   appreciated!

[Dr. Elliot Jacobs]

Scar tissue post surgery, often "spoiling" the nice initial results, is very common.  It is extremely variable and unpredictable -- Mother Nature can be very fickle!

I usually recommend twice daily massage for it and lots of patience, for it frequently reduces by itself.  After 4-6 months, if it still persists, I will then begin a single or series of injections with Kenalog (a good steroid), which will melt away the scar tissue.  Care must be taken because too much Kenalog can lead to atrophy and thinning (and a depression) of the tissues. 

Many patients seek to have immediate surgery to remove the scar tissue. This is the wrong approach because if you cut out scar tissue, the body will simply heal with more scar tissue.

Some people talk about the possible need for revision surgery for re-growth of breast tissue -- this ALL falls in the category of scar tissue, for immediate re-growth of breast tissue is almost unheard of.  Patience, massage, observation and judicious injections of Kenalog are the better way to go in most cases.  Obviously, your own surgeon is the best source for your individual concerns.

Elliot Jacobs, MD, FACS

[PaulSW]

I'm 18 weeks post op and have a large lump under my left side which is pushing out my nipple. These injections sound great do you know when can you start having them?

[Dr. Elliot Jacobs]

Every patient is different and every surgeon's routine post op care is different -- would advise you consult your surgeon and follow his/her advice.

Dr Jacobs

[matthew1]

crap, seems like a  whole new set of problems develop after gyne surgery.
     I was hoping  for  surgery and a few weeks later being  able to take my shirt off,

[Dr. Elliot Jacobs]

Matthew1

I agree with you.  Part of the challenge of surgery is that you can do a fabulous operation -- it all looks great on the operating table.  And then the unpredictable part of the procedure occurs -- it is called healing.  Very quirky, very individual and totally unpredictable.  That is because we are dealing with living tissue, which often doesn't do what we want it to do.

Dr Jacobs

[Grandpa Bambu]

Matthew1

I agree with you.  Part of the challenge of surgery is that you can do a fabulous operation -- it all looks great on the operating table.  And then the unpredictable part of the procedure occurs -- it is called healing.  Very quirky, very individual and totally unpredictable.  That is because we are dealing with living tissue, which often doesn't do what we want it to do.

Dr Jacobs

Awesome post Dr. Jacobs!!! 

Yet another post by Dr. Jacobs that should be in a 'FAQ' or 'Fact' section Merle....


From what I have read over the years, many post-oppers have the belief that surgery is a Cut'n Dry procedure. Sorta like if you wipe out the fender on your car... Remove the old, bolt on the new and you're good to go.... Well, surgery/healing isn't like that guys! 

GB

[cool]

PLEASE HELP ME OUT will kenalog shots still be effective a 9 months post op? I had surgery with JCF and i'm interested in getting these shots, also are there any costs?

[Dr. Elliot Jacobs]

If there is a buildup of scar tissue after surgery, Kenalog injections will work at any time -- you have not lost anything by waiting and massaging.

My office policy is to provide these injections at no charge -- other surgeons may differ.  It is worth discussing this, if possible, prior to one's gyne surgery.

Elliot Jacobs, MD, FACS

[cool]

thank you, Dr. Jacobs your help is much appreciated. I will contact my PS about these shots ASAP 

[Dr. Elliot Jacobs]

Everyone heals with scar tissue -- that is Mother Nature's method of healing a wound.  The development of excess scar tissue is extremely variable and totally unpredictable in any individual.  However, it does take time for scar tissue to develop so that worrying about scar tissue at one or two weeks post op is premature.  If the surgeon did his job well and removed all of the appropriate tissue, then the hardness you may feel at such an early time post op is most likely localized swelling and/or a small, localized blood clot.

Elliot Jacobs, MD, FACS