Intraoperative Hyaluronic Acid Gel Injection for Improvement of Scar Quality Following Reduction Mammaplasty

Inclusion Criteria: * adequate organ function (BUN \< 4.0 mmol/L; serum creatinine \< 120 micromol/L; Hgb \> 100 g/L; WBC \> 4,000/mm3 and \< 12,000/mm3; platelets \> 100,000/mm3) * age 18 years or older, with a minimum life expectancy of 2 years * current non-smoker * American Society of Anaesthesiology score of 1 or 2 * ability to provide informed consent Exclusion Criteria: * previous history of breast surgery; known allergy to polyglactin, poliglecaprone, or injectable hyaluronic acid gel (Restylane or Prevelle) * history of current or recent (\<2 months) immunosuppression * documented hypersensitivity to streptococcal products * acute or chronic skin diseases such as folliculitis or psoriasis * history of bleeding dyscrasia or active anticoagulation (INR\>2.0) * pregnancy or active breast-feeding * any additional surgical procedures performed in the same surgical session in the same anatomical region * personal or family history of susceptibility to keloid or hypertrophic scar formation * Fitzpatrick skin type 5 or 6.