AboutAlan M. Engler, MD, FACS Expertise Dr. Engler has answered over 2700 plastic surgery questions for Allexperts. His expertise is in cosmetic plastic surgery including breast surgery (breast enlargement with implants, breast reduction, breast lifts), liposuction, eyelid surgery, tummy tucks, facelifts etc.
Dr. Engler has been listed as one New York`s Top Doctors, and as "One of the World's Most Famous Aesthetic Surgeons" (Aesthetic Surgery, TASCHEN Books, Angelika Taschen, Editor). He is the author of 4 books, including "BodySculpture" (a best-selling plastic surgery book on breast surgery, liposuction and tummy tucks), "EyeScapes" (Plastic Surgery of the Eyelids), "Restylane," and "The Slim Book of Liposuction."
Dr. Engler has two US Patents for surgical instruments that he's designed, and has appeared on numerous television shows, including The Tyra Banks Show, The Ricki Lake Show (four times), and the Dr. Keith Ablow Show. Videos of his appearances are available on YouTube (SEARCH FOR "DR. ENGLER"). His website is www.bodysculpture.com.
Experience Dr. Alan Engler is a board-certified plastic surgeon in New York and the author of BodySculpture - Plastic Surgery of the Body for Men and Women (ISBN 0966382749) one of the top-selling plastic surgery books on amazon.com, barnesandnoble.com, etc.
Education/Credentials Dr. Engler graduated from Yale University (undergraduate) and the College of Physicians and Surgeons of Columbia University (medical school). He did his residency training in General Surgery and, after that, Plastic Surgery, at the Montefiore Medical Center in New York. He is on the faculty of the Albert Einstein College of Medicine in New York.
I had reduction surgery just over one year ago. I am very fair skinned. I had the surgery at Kaiser as a medically necessaru procedure, not an expensive cosmetic surgeon. My scarring is still very noticeable despite 9 months of cortisone shots, creams, silicone sheets, etc. Around the areolas is especially messy and irregular looking. I want to know how small the stitches should have been (mine were about 2 to the inch) and what is the best treatment for improvement of these ugly scars?
Answer from Dr. Alan Engler
www.bodysculpture.com
Dear Melissa,
I'm obviously very sorry for the scarring problems you've had as a result of your breast reduction. Scarring is certainly one of the unknowns with this, and many other, surgical procedures.
In terms of what sutures should or could have been used, there are actually many different types of suturing methods and what you see on the surface typically represents only a small percentage of all the suturing that was done. If there were only two to an inch, then I suspect that most of the suturing was beneath the surface, with only those few sutures in the skin used to further support the closure. The operative report would typically indicate what type of suturing, which material, etc., were used.
At this point, I might consider a scar revision. For whatever reason, the scarring is very thick and hypertrophic, despite lots of appropriate things that have been done (steroid injections, silicone sheets, etc). There is, of course, no guarantee that the same thing won't happen again, but it sounds like it may be worth it at this stage, since things have certainly not settled down as anyone hoped.
Before doing any of that you should, of course, go for a few more consultations (I would say at least two) just to get some other ideas about options.
Again, I'm sorry about that but I hope that this has helped.
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