Breast Surgery Scars: What to Expect and How to Minimize Them

Scarring is an inevitable part of breast surgery. While modern techniques minimize their visibility, understanding what to expect and how to optimize healing helps you achieve the best possible outcome.

How Surgical Scars Form

When skin is cut, the body produces collagen to repair the wound. This healing process creates scar tissue that differs from surrounding skin. Scar maturation takes 12-18 months, during which scars gradually fade and flatten.

Incision Locations by Procedure

Breast Augmentation

• Inframammary (under the breast): Most common; hidden in breast crease
• Periareolar (around the nipple): Hidden at areola border
• Transaxillary (armpit): Scar hidden in armpit
• Transumbilical (belly button): Only for saline implants (rare)

Breast Lift

• Periareolar/Donut: Scar only around areola (mild lift)
• Vertical/Lollipop: Around areola plus vertical line (moderate lift)
• Anchor/Inverted-T: Around areola, vertical, and along crease (significant lift)

Breast Reduction

• Similar patterns to breast lift
• Most commonly anchor/inverted-T incision
• Scar extent depends on amount of tissue reduced

Breast Reconstruction

• Varies widely based on technique
• Mastectomy scars already present
• Flap procedures involve donor site scars as well

Factors Affecting Scar Quality

Several factors influence how your scars heal:

Genetics

Your genetic predisposition significantly affects scarring. Some people naturally form flat, fading scars while others are prone to raised or discolored scars.

Skin Type and Color

• Darker skin tones have higher risk of keloid or hyperpigmented scars
• Very fair skin may develop more visible red or pink scars initially

Age

Younger skin generally heals better, though it may initially produce more visible scars that fade over time.

Surgical Technique

Experienced surgeons use techniques that minimize tension and trauma, promoting better healing.

Post-Operative Care

Following your surgeon's wound care instructions is crucial for optimal scar outcome.

Abnormal Scarring

Hypertrophic Scars

• Raised and red
• Stay within the original incision boundaries
• Often improve over time
• Can be treated if problematic

Keloid Scars

• Raised and extend beyond incision boundaries
• More common in certain ethnicities
• May require treatment
• Discuss risk with surgeon if you have history of keloids

Widened (Stretched) Scars

• Result from tension on healing wound
• Often from returning to activity too soon
• May require revision surgery

Timeline of Scar Healing

Weeks 1-2

• Incisions healing, may appear red or slightly raised
• Sutures dissolve or are removed
• Keep dry per surgeon instructions

Weeks 2-6

• Scars may appear more red or dark
• This is normal—scars often look worse before better
• Begin scar treatment when wounds fully closed

Months 2-6

• Color begins to fade
• Texture may still be raised
• Continue scar care routine

Months 6-18

• Most improvement occurs during this time
• Scars flatten and lighten
• Final results become apparent

Proven Scar Minimization Techniques

Silicone

The gold standard for scar treatment:

• Silicone sheets: Worn over scars for 12+ hours daily
• Silicone gels: Applied twice daily once incisions fully closed
• Shown in studies to flatten, fade, and soften scars

Sun Protection

Critical for optimal scar appearance:

• UV exposure permanently darkens scars
• Cover scars or use SPF 50+ for at least one year
• Continue sun protection even after scars mature

Massage

Once incisions are fully healed (usually 2-3 weeks):

• Gentle massage breaks down scar tissue
• Improves flexibility and flattening
• Use with lotion or silicone gel
• 5-10 minutes, twice daily

Pressure

Compression garments or silicone sheets provide gentle pressure that:

• Reduces scar thickness
• Speeds maturation
• Particularly helpful for raised scars

Embrace or Embrace-Type Devices

Tension-reducing devices placed along incisions that:

• Reduce mechanical stress during healing
• Result in significantly finer scars
• Used immediately after surgery in some cases

Medical Treatments for Problem Scars

If scars don't respond to home care, options include:

Steroid Injections

• Flatten raised scars
• May lighten color
• Series of injections typically needed

Laser Treatment

• Reduces redness
• Improves texture
• Multiple sessions usually required

Scar Revision Surgery

• For significantly problematic scars
• Removes original scar and re-closes
• Combined with other techniques to improve outcome

Best Practices for Optimal Healing

Before Surgery

• Stop smoking (impairs healing significantly)
• Avoid blood thinners as directed
• Optimize nutrition

After Surgery

• Follow all wound care instructions exactly
• Keep incisions clean and dry
• Don't pick at scabs or sutures
• Avoid stretching or tension on incisions
• Wear surgical bra as directed

During Scar Maturation

• Begin scar treatment when cleared by surgeon
• Be consistent—results require ongoing care
• Be patient—improvement continues for months
• Protect from sun exposure

Realistic Expectations

Even with optimal care, scars are permanent markings that show surgery occurred. The goal is scars that:

• Blend with surrounding skin
• Are flat or minimally raised
• Are barely noticeable from normal viewing distance
• Don't cause physical symptoms

Most breast surgery patients find their scars fade enough to be an acceptable trade-off for their improved breast appearance. With proper care and patience, your scars should become subtle reminders of your transformation rather than prominent features.