Scar Healing after Breast Reconstruction: A 5-year Follow-up in Asian Patients.

OBJECTIVES

Hypervascularity, hypertrophy, and hyperpigmentation of breast scars often persist for several years after reconstruction. There are few reports on the long-term follow-up of postoperative scars after breast reconstruction. We previously reported that at 1 year after reconstruction, >30% of Asian patients showed abnormal scars. In this study, we followed these patients for as long as 5 years postoperatively.

METHODS

We followed 101 Asian patients who underwent immediate two-stage implant-based breast reconstructions between 2013 and 2017 and still had abnormal scars involving hypervascularity, hypertrophy, or hyperpigmentation at 1 year postoperatively. We conducted annual follow-up for an additional 4 years, assessing the time until improvement and performing statistical analysis of factors related to the persistence and healing of abnormal scars.

RESULTS

Hypervascularity improved in 12%, 37%, 68%, and 82% of patients at 2, 3, 4, and 5 years, respectively. Most cases improved between 3 and 4 years postoperatively. Among the patients with both hypervascularity and hypertrophy at 1 year, 36% had residual hypervascularity at 5 years compared with 9.8% of those with hypervascularity only at 1 year. Hypertrophy improved within 5 years in 56% of the cases. Hyperpigmentation improved within 5 years in only 21% of the cases. There was no significant association between abnormal scars and age or body mass index.

CONCLUSIONS

Even in Asian patients with persistent hypervascularity of breast scars, most cases improve within 5 years after reconstruction. However, hypervascularity tends to persist in cases that also show hypertrophy. Compared with hypervascularity and hypertrophy, hyperpigmentation showed worse 5-year improvement.