Topical silicone sheets in the prevention of hypertrofic scars after reductive mammaplasty

Excessive scarring caused by pathologically overabundant collagen deposition is a well known problem. Hypertrophic scars and keloids are fibroproliferative diseases of the skin. We can define an hypertrophic scar as an elevated scar that is typically raised, erythematous (red, pink or purple) and suffer than the surrounding skin. These types of scars are more common in areas with slow wound healing response, such as the anterior chest, breast, or in movement-dependent areas such as the scapula, the elbow, or the knee. We chose to treat vertical mammary scar in Stanford reductive T-inverted mammaplasty because hypertrophic scars are quite common in breast, aesthetically important and poorly tolerated by patients. We studied 40 patients who underwent a standard reductive T-inverted mammaplasty under general anesthesia between May 2007 and August 2008. In twenty patients, vertical scars were treated with a silicone sheet in the postoperative period bilaterally while in the control group (twenty patients) scars were not treated. The treated scars showed improvement for all parameters considered when compared with the untreated control scars. In our opinion silicone topical sheets are potentially useful for hypertrophic scar prophylaxis when applied in the postoperative period.