Question for Dr. Bermant or Dr. Jacobs??? Scarring after 10 years.

[S80]

Hello,

I had surgery about 10 years ago. I have noticed my scar under my nipple stretching and it goes up my nipple a little bit especially on my right nipple. Its about a 1/4 inch up the nipple. Its kind of a lighter color then the rest of my nipple and its starting to become pretty noticeable and I am becoming self conscience about it. Its a light pink color. I am wondering if this happened because I usually don't use sunscreen on it and have exposed it to a lot of sun over the years.

Should I put sunscreen on it still or should I tan it to blend better?

Is there anything I can do this late after surgery?


thank you!

[Dr. Elliot Jacobs]

It would really be helpful if you could post a really clear, sharp close-up photo of the scarred nipple. (Use a camera with a capability of macro close-up photos). I could then try to provide a better answer for you.

Dr Jacobs

[S80]

Will this work? I don't have a very good digital camera.

[Dr. Elliot Jacobs]

It appears that you have a scar completely around the edge of the areola -- and then some de-pigmentation of the areola extending upward from the scar at the bottom.  I really can't tell from the photo whether the scar is stretching or if there is just de-pigmentation of the lower portion of the areola.

Ten years is a very long time after surgery to be seeing any further changes.  I really don't think sun tanning or sun block is going to do anything for you.

Perhaps the best thing to consider is to go to a medical tattoo artist who could match the color of your areola and put some pigment into the area of pigment loss.

You could also try putting cocoa butter on it daily -- sometimes it can help to bring the pigment back -- but it may take up to 6 months or more to see results.

Good luck!

Dr Jacobs

[DrBermant]

Hello,

I had surgery about 10 years ago. I have noticed my scar under my nipple stretching and it goes up my nipple a little bit especially on my right nipple. Its about a 1/4 inch up the nipple. Its kind of a lighter color then the rest of my nipple and its starting to become pretty noticeable and I am becoming self conscience about it. Its a light pink color. I am wondering if this happened because I usually don't use sunscreen on it and have exposed it to a lot of sun over the years.

Should I put sunscreen on it still or should I tan it to blend better?

Is there anything I can do this late after surgery?


thank you!

Will this work? I don't have a very good digital camera.

Tanning is unpredictable, scars tend to tan differently and tans from scars can fade differently from surrounding skin.

Scars can have different pigmentation from surrounding tissues. This can involve the darker areola or the basic chest skin. Your image is not enough to determine options. This can change based on general body pigmentation, tanning, and other factors. Scars just do not act like other tissue as far as pigmentation issues. This late out, Scar Care typically has little value. Pigmentation changing creams, bleaches darkening agents tend to be more for general regions. It is nearly impossible to spot chemically treat without the surrounding nearby regions being affected. Tattoos, putting permanent matching colors in the skin is an option, but over long term evolution, even this pigment migrates (look at older tattoos.) Some use camouflage makeup such as Dermablend, but this requires skill and a male willing to work with makeup.

Sometimes Revision Areola Scar from Prior Gynecomastia Surgery is an option. Such issues are best explored during a consultation after an evaluation. But then you would be starting with a new scar, scar care, and healing at an older age.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Male Breast Reduction

[S80]

Thank you both so much for the information!

So you think its worth a try to put coco butter on it? Or is it a long shot at working?
I am willing to try anything. It seems like the easiest thing to try first.

thank you,

[Dr. Elliot Jacobs]

No downside to trying it -- it is very inexpensive but you will have to give it many months to see any improvement if at all.  Hint:  don't micro-scrutinize it on a day to day basis.

Dr Jacobs

[DrBermant]

Thank you both so much for the information!

So you think its worth a try to put coco butter on it? Or is it a long shot at working?
I am willing to try anything. It seems like the easiest thing to try first.

thank you,

I have never seen the cocoa butter help with pigmentation issues. Before embarking on such a task, try to find before / after pictures of the method working for pigmentation. If something works, it should be able to be documented with decent photos at least with pigmentation. However, I have seen cocoa butter help with scars and scar care. But the physical nature of scars is difficult to quantify. That is why testing of scar care products is so difficult. Pictures are not sufficient to document such issues with the feeling nature of scars, but with pigmentation such imagery should be available.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Male Breast Reduction

[Dr. Elliot Jacobs]

I disagree with Dr Bermant.  I have seen pigment return to scars and areolas with only the use of cocoa butter -- this particularly works well with African Americans.  In fact, it was an old trick that was taught to me by an African American patient.  (Yes, I do learn from my patients).

I can't imagine what the downside would be if you used the cocoa butter -- other than it didn't work!  The only fly in the ointment here is that is has been so long since your original surgery.

Dr Jacobs

[S80]

Is massaging it into the scar important? Or should I just apply it.

thanks!

[Dr. Elliot Jacobs]

Simply apply it once or twice a day.

Dr Jacobs

[S80]

Ok, one more question.

Is it possible that it could make the scar worse? The reason I ask is because in a way I don't want the scar to get lighter because it contrasts with the nipple color. I would want the scar to go away and the nipple skin under the scar to reappear. If that is impossible and its just going to get whiter and whiter then that would be a bad thing. Your thoughts?

Also, maybe I should find a makeup for it. Not sure where to start with that....


thanks for all your help!