Scars are part of surgery
Any operation that cuts the skin leaves a scar. In breast surgery, surgeons plan incisions to be as discreet as reasonably possible, often placing them in natural folds or at the edge of the areola. Still, a scar is permanent, and no technique can promise how yours will look.
Being informed about scars before surgery is part of making a good decision. For some people, scar placement is the deciding factor between options.
Where the scars go
The location depends on the procedure and on your anatomy. Smaller changes generally use shorter incisions; operations that remove or reposition skin need longer ones.
- Augmentation: usually a short scar in the fold under the breast, around the lower edge of the areola, or occasionally in the armpit
- Breast lift: around the areola; sometimes also vertically down to the fold; sometimes along the fold as well, depending on how much skin is removed
- Breast reduction: commonly around the areola and vertically, with an additional scar along the fold in some cases
- Fat transfer: tiny puncture scars at the injection and liposuction sites
- Revision or implant removal: often reuses an existing scar, though this is not always possible
How a scar matures
Scar healing happens in phases. In the first weeks the incision closes and may look pink or red. Over the next several months the scar can become firmer, raised, or darker as the body builds collagen. From about six months to two years, most scars gradually soften, flatten, and fade, often becoming paler than surrounding skin.
This means a scar that looks worrying at two months is not necessarily the final result. Patience, and follow-up with your surgeon, matter.
What influences how you scar
Several things affect scarring, and some are outside anyone's control. Genetics play a large part: some people form wider, thicker, or darker scars regardless of technique. Skin tone can matter, as people with deeper skin tones may be more prone to hyperpigmentation and to raised keloid scars. Tension on the incision, smoking, infection, and delayed healing can also worsen scars.
Types worth knowing about include widened scars, hypertrophic scars (raised but staying within the incision line), and keloids (extending beyond it). If you have formed unusual scars before, tell your surgeon at the consultation.
Supporting healing, and treatment options
Your surgeon will give specific aftercare instructions. General approaches that are commonly recommended include the following, though their evidence and benefit vary between people.
- Not smoking or using nicotine products, which impairs healing
- Keeping incisions clean and following dressing instructions
- Protecting scars from sun with clothing or sunscreen once healed enough, since UV can darken them
- Using silicone sheets or gel, if recommended, once the incision has closed
- Gentle massage when your surgeon says it is safe
If you are unhappy with a scar
Options exist for problematic scars, depending on the type, including steroid injections, laser or light-based treatments, and in some cases scar revision surgery. Waiting until the scar has matured, often about a year, is generally advised before judging or revising it.
If you are still weighing surgery, ask your surgeon to show you where the incisions would go on your body and to talk about the trade-offs. It is a fair question to ask, and it is also fair to decide the scars are not a trade you want to make.