3 months post donut lift surgery photos - thinking about a revision

[Runners]

I had a donut lift 14  weeks ago in Washington DC by Dr. Steven Davison.  This is my pre-op photo:



Dr. Davison suggested to perform a donut lift versus a smaller incision under the areola. He explained he could remove the excessive skin as well as the tissue and fat which would produce a better result.  I underwent the surgery on May 10th.

14 works later I have some issues with the result. Despite massaging, injection and using the silicone sheets the scars are bad. On the sides there is scaring and visible folds where the drain tubes were installed.


The drain tube left a line and my chest somewhat sags below the line. When I consulted Dr. Davison he said the line is caused my chest muscle.  The fact that it is consistent with the tube location on each side and I didn't have it before (pre-op picture on the right), leaves me to believe it is caused by the drains.


 

The scars are red and becoming bright and shiny. It only happens on the top of areola which I think is due to higher tensions on the top. Could this be managed with more reinforcement of stitches during surgery?
 


I'd like to know your opinion about the results. I am seeing Dr. Davison in 6 weeks and I'd like to discuss my options with him. We have talked about the possibility of a scar revision and smoothing of the  tissue with liposuction but no specific plans yet. Thank you.

[DrPensler]

Your scars are still very red. The redness means that the scars are not mature.I typically would allow the scars to mature prior to any revision.These are tough problems and often take time to resolve even in the best circumstances.

[Runners]

Is the redness after 3 months normal for a donut lift procedure? The scars are red only on the top of the areola. Would this be caused unmanaged tension? My worry is the scar is not caused by the incision, my skin is just stretching to offset the tension.

[Litlriki]

Red scars at 3 months are not unusual.  The redness can take many months to resolve, depending in large part on your personal biology and propensity toward scarring.  I typically wouldn't even consider any sort of revision before 9 months to a year, especially of the scar.  Other contour issues may continue to improve as well.  While most of my routine gynecomastia patients (without skin removal or excess skin laxity pre-op) look pretty good by their 6 - 8 week follow up, those with more complex procedures, including peri-areolar skin removal, require much more time for complete resolution.

Rick Silverman

[Dr. Elliot Jacobs]

Agree with my colleagues -- your scars are red and immature -- they need lots of time to heal and settle down.  Be aware that the more complicated the operation (and a donut lift is complicated), the longer it takes to heal completely. 

Best to be patient.

My own personal preference is not to do a donut lift in many patients because of the anticipated scarring. 

Dr Jacobs

[Runners]

What does work in your experience to reduce the shininess of the scars?  Should i restrict my chest movement and avoid the pool water? I am alternating between silicone sheets and paper tape.

Ultimately the donut procedure has cost me a lot of time and effort, which almost defeats the purpose of the surgery.  I was onboard with the idea of removing the skin but the scar management issues have become very inconvenient.

Thank you very much for your responses. I hope it helps someone in a similar situation.

[Dr. Elliot Jacobs]

The red and shiny aspect of the scars indicate that they are immature and under tension.  Until time has passed and the tension of the surrounding skin pulling against the areola has diminished, one may expect it to continue.  There is no need to avoid swimming or chest movement.  And silicone sheets or other devices are really best used to prevent a raised (above the skin surface) scars, which you do not have.  Certainly there is no harm to using them but whether they actually will help is questionable.

You could perhaps visit a dermatologist who is well versed in the use of various lasers.  Perhaps you can get some help there but ultimately, only time will be of help.

Dr Jacobs

[DrPensler]

Red and shiny equals immature for scars.You can use scar-guard,mederma,silicone or tape to accelerate maturation of the wound.

[Runners]

I use tape and silicone sheets to help the scaring process and I am giving it time. I don't know how much improvement I can expect. This a shot from today. Aside from the scaring, the contour doesn't seem right,