Scars and Scar Care After Breast Surgery
At a Glance
- ✂️Fine suturing technique minimises scars
- ⏱️Healing time: up to 12 months
- 💊Regular care is essential
- 🤲Scar massage promotes healing
- 🌞Sun protection for 12 months
"Raised and unsightly scars after breast surgery are not inevitable. Scar care after breast surgery is absolutely essential."
Breast Surgery and Hand Surgery – what do they have in common?
At first glance, breast surgery and hand surgery appear to have nothing in common. However, on closer inspection, one finds that the two subjects are very closely interlinked.
Delicacy and Precision
Hand surgery is a subspecialty of plastic surgery that demands great manual dexterity and meticulous, fine work from the surgeon. The hand contains delicate structures such as tendons, nerves, blood vessels, and bones in close proximity. Delicacy and precision in procedures are therefore essential.
Operating on such fine structures also benefits the plastic surgeon in breast surgery. It enables them to perform breast augmentation, and particularly breast reduction and breast lift procedures, in an especially scar-sparing manner with very fine sutures.
Scars After Various Breast Surgeries
Scars After Breast Augmentation
Less conspicuous, as the incision is placed in inconspicuous locations: at the areolar border or beneath the inframammary fold. When the incision is placed in the inframammary fold, the scar is concealed by the breast itself and is therefore almost "invisible".
Scars After Breast Reduction
With the T-incision or L-incision technique, scars are visible. They run from the nipple down across the breast to the inframammary fold.
✓ Thanks to particularly fine sutures, these scars fade very well and are barely visible after wound healing.
Breast Lift Scars
The scars vary depending on breast size and the technique used:
- • Periareolar: Incision around the areola (Benelli)
- • Vertical: From the lower areolar border to the inframammary fold
- • L-shaped: Additionally along the natural inframammary fold
- • T-shaped: For large breasts with significantly ptotic skin
Scars After Gynaecomastia Surgery
Very small and inconspicuous. They run in a crescent shape around the nipple and are only recognisable as fine lines after healing. A further small scar (3 mm) for the liposuction cannula runs laterally over the costal margin – no longer visible after healing.
Healing Process: 12 Months to Complete Resolution
The healing process passes through various stages. The surgical scar may appear swollen, purple, or reddish, but will gradually become smoother and less noticeable over time.
Suture Removal
Approximately 14 days after breast surgery, the sutures are removed. Scar care can begin thereafter.
Intensive Care
At least 3 months of daily scar care with creams, gels, or silicone dressings for optimal results.
Complete Healing
Only approximately one year after breast surgery is the scar fully healed and has reached its final appearance.
Risk Factors for Unsightly Scars
In breast surgery, the incision technique is decisive for scar formation. However, in addition to the incision technique, other factors play an important role in wound healing:
Genetic & Hormonal Factors
- • Genetic predisposition
- • Puberty or menopause
- • Skin type and age
Wound Healing Disorders
- • Chronic inflammation
- • Wound infections
- • Delayed epithelialisation
Mechanical Factors
- • Tension at wound edges
- • Premature strain
- • Lack of compression
Systemic Conditions
- • Diabetes mellitus
- • Immunodeficiency
- • Metabolic disorders
Scar Care After Breast Surgery – Absolutely Essential
Targeted scar care after breast surgery can support scar healing. After suture removal (approximately 14 days post-op), the scar should be cleaned and moisturised daily.
Care Products
- • Scar ointment (specialist formulations)
- • Scar gel (lightweight texture)
- • Silicone scar dressings
- • Vaseline, Bepanthen
- • Fragrance-free body lotion
Important Measures
- • Wear appropriate compression garments
- • Regular scar massage
- • Keep scar soft and supple
- • At least 3 months of care
- • Sun protection for 12 months
Do's
- ✓ Protect the body and scar
- ✓ Daily cleaning and care
- ✓ Healthy diet
- ✓ Drink sufficient fluids
- ✓ Regular check-ups with your doctor
Don'ts
- ✗ Straining the breast too early
- ✗ Exposing the scar to sunlight
- ✗ Massaging too firmly (too soon)
- ✗ Smoking (delays healing)
- ✗ Alcohol in the first few weeks
Frequently Asked Questions
When can I begin scar care after breast surgery?
You can begin scar care as soon as the sutures have been removed – typically around 14 days after the operation. Before this, you should keep the wound dry and clean and follow your surgeon's instructions. From the point of suture removal, daily care with specialist scar ointments, gels, or silicone dressings is recommended.
Which scar care products are most suitable?
There are various effective products available: specialist scar ointments containing onion extract or dexpanthenol, silicone gel or silicone dressings, and simple care products such as Vaseline or Bepanthen. Silicone-based products have been shown to be particularly effective in studies. Most importantly, regular and consistent application over at least 3 months is key. Your surgeon can provide specific recommendations.
How do I perform a scar massage correctly?
Begin massage only after complete wound healing (approximately 2–3 weeks after suture removal). Gently massage the scar using circular movements, applying a moisturising cream or scar gel. Perform the massage 2–3 times daily for 5–10 minutes each time. The massage should feel slightly uncomfortable, but must not be painful. It helps to keep the scar tissue supple and release adhesions.
How long does it take for scars to fade after breast surgery?
The healing process takes up to 12 months. In the first few weeks, scars may be red, swollen, and raised. After 3–6 months, they begin to fade and become flatter. The final appearance only becomes apparent after approximately one year. Scars in the breast area generally heal very well and become increasingly inconspicuous over time, particularly with consistent care.
Why is sun protection for scars so important?
Scar tissue contains less melanin than normal skin and is therefore more sensitive to UV radiation. Sun exposure can lead to permanent pigmentation of the scar – it may then become darker than the surrounding skin and appear more prominent. Protect scars consistently from sunlight for at least 12 months using clothing or sunscreen with a high SPF (50+). This is essential for an inconspicuous final result.
Can scars after breast surgery disappear completely?
Scars cannot disappear entirely, but they can fade over time to the point where they are barely visible. With a fine suturing technique, consistent scar care, and favourable individual conditions (skin type, age, genetics), scars often become fine, pale lines that are barely noticeable in everyday life. With breast augmentations in the inframammary fold, scars are frequently practically invisible, as they are concealed by the breast itself.
What can I do if a raised scar (keloid) develops?
If a raised, thickened scar (hypertrophic scar or keloid) develops, you should consult your surgeon promptly. Treatment options include: corticosteroid injections directly into the scar, pressure therapy with specialist compression dressings, laser therapy for scar smoothing, and in severe cases, surgical scar revision. Prevention is preferable, however: regular massage, compression, and silicone products can help prevent raised scars from forming.
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Über den Autor
Facharzt für Plastische und Ästhetische Chirurgie & Handchirurg
Mit mehr als 30.000 Eingriffen und mehrjähriger Tätigkeit als Chefarzt führt Dr. Schuhmann seit 2016 als Gründer von artethic® seine Praxen in Düsseldorf und Berlin.