A question I am frequently asked by patients prior to breast augmentation at my Phoenix medical office is, “How likely is it that I’ll develop stretch marks?” Thankfully, the answer to that question is “extremely unlikely,” but there are some factors patients need to understand that can affect their risks for stretch marks.
I have performed many hundreds of breast augmentations using all types and sizes of breast implants for Scottsdale and Phoenix women and I can only remember 2 or 3 patients ever developing significant stretch marks as a direct result of surgery. Therefore, stretch marks are not a complication I usually worry about for my patients. However, I will assess a patient’s risk for stretch marks and advise her on how to lower the chances of developing skin irregularities.
For the most part, the tendency to form stretch marks is genetic. Stretch marks are caused by small rips in the deep layer of skin called the dermis. Once they occur, they can cause a red or pink appearance, or they can cause thinning of the overlying skin. Contrary to popular belief, cocoa butter and other ointments do not prevent stretch marks in people who are predisposed to forming them. Rapid expansion of skin in patients with poor skin elasticity and weak skin strength is the main factor.
Before breast augmentation, I assess each patient’s skin quality. Patients with thin, weak skin will not tolerate large implants as well as patients with strong, elastic skin. With these patients, I am more cautious about placing bigger implants, as they are at risk not only for stretch marks but also for skin stretching and drooping. The less weight the skin has to support, the better the breasts will hold up.
Patients who have a history of severe stretch marks on other areas of their bodies, such as the legs, buttocks or abdomen, are at higher risk for breast stretch marks (once again, because of genetic predisposition). I caution these patients about the risk so they can factor it into their decision about whether to have implants placed.
Ultimately, the risk for stretch marks is low, and those patients who get stretch marks with breast augmentation would also likely get them with breast growth during pregnancy. However, implant size and weight should certainly be factored into the decision-making process in patients with thinner and weaker skin. This is one of the many factors I evaluate in order to obtain the best results for my patients, and it is another reason why each surgery must be customized to the individual patient.