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There is a risk of scarring with any operation and patients must consider not only the immediate and long-term results of surgery and the anaesthetic, but also the cosmetic result. This patient elected for breast reduction but was left with unsightly hypertrophic scars. As a wound heals, initially there is prominence and redness of the scar, which becomes flatter and paler. If there is much tension on the wound, a hypertrophic scar may be thicker than usual. Spontaneous improvement usually occurs after 12 to 18 months.
In some cases an imbalance occurs in healing, resulting in production of excess collagen, which causes …