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Striae Distensae after Breast Augmentation: Treatment Using the Nonablative Fractionated 1550-nm Erbium Glass Laser

Pacheco Guimarães, Paulo Afonso Monteiro M.D.; Haddad, Alessandra M.D., Ph.D.; Sabino Neto, Miguel M.D., Ph.D.; Lage, Fabiana Claudino; Ferreira, Lydia Masako M.D., Ph.D., M.B.A.

Plastic & Reconstructive Surgery: March 2013 - Volume 131 - Issue 3 - p 636–642
doi: 10.1097/PRS.0b013e31827c7010
Cosmetic: Original Articles

Background: Stretch marks, or striae distensae, are dermal scars and result in considerable aesthetic concern. The responsible factors for their development are poorly understood. Development of striae distensae is a rare complication after breast augmentation. Successfully treating striae distensae has always been challenging. Lasers and light devices have recently become a good therapeutic option. The fractional laser has shown encouraging results with less risk of pigmentation in the treatment of recent stretch marks.

Methods: Forty-seven patients underwent breast augmentation over a period of 2 months; of these, 10 patients developed new striae distensae. They were submitted to nonablative fractionated 1550-nm erbium glass laser treatment. Response was assessed from photographs obtained before and 4 weeks after the end of treatment. Two plastic surgeons analyzed improvements clinically and photographically, and a patient satisfaction score was recorded as well.

Results: There was a significant relationship between age and development of striae, (p = 0.003), but there was no significant relationship between striae distensae and nulliparity (p = 0.147), volume of the silicone implant (p = 0.892), or use of oral contraceptive (p = 1.00). The scores achieved by both the evaluators and the patients were high, with 50 percent of them between 9 and 10 (maximum scores), and with a high index of satisfaction with the treatment.

Conclusions: Age is statistically significant in the development of striae distensae after breast augmentation. This report demonstrates excellent patient and plastic surgeon satisfaction after treatment. The use of fractional photothermolysis is a good treatment modality for striae rubrae.

CLINICAL QUESTION/LEVEL OF EVIDENCE: Risk, IV.

São Paulo, Brazil

From the Division of Plastic Surgery, Department of Surgery, Universidade Federal de São Paulo.

Received for publication June 30, 2012; accepted September 24, 2012.

Disclosure: The authors have no financial interest or commercial association with any of the subject matter or products mentioned in this article. There was no external funding for this study.

Paulo Afonso Monteiro Pacheco Guimarães, M.D.; Division of Plastic Surgery, Universidade Federal de São Paulo, Rua Napoleão de Barros 715, 4o. andar, CEP 04024-002 São Paulo, Brazil, pa.cirurgia@gmail.com

©2013American Society of Plastic Surgeons