Scars after plastic surgery: how to care for them

How does a surgical scar change over time?

A scar goes through stages, and the early weeks are not a guide to the final look. At first it is usually red, pink or purple and can feel firm, raised or tight. After a breast lift, for example, scars are typically red and slightly raised at around 6 weeks and still new at 6 months, while facelift scars fade from red to purple to pale.

Over the following months the scar flattens and fades towards your skin tone. Most surgical scars take 12–18 months to mature, and some take longer: after a body lift, the scars mature over 18–24 months.

Where will your scars be?

Surgeons place incisions where they are easiest to hide, such as natural creases, the hairline or areas covered by underwear, and the trade-off is usually between scar length and how much can be changed. Ask to see where your scars will run before you sign the consent form: some, such as arm and thigh lift scars, are long and hard to hide.

• Face: in the hairline and the creases around the ear after a facelift, where they can be harder to hide in men because of the beard line and short hair, and in the upper-lid crease after eyelid surgery.
• Nose: inside the nostrils after closed rhinoplasty; the open approach adds a fine scar on the strip of skin between the nostrils.
• Breasts: usually in the fold under the breast for implants, and around the areola, down to the fold and sometimes along it after a breast lift or reduction.
• Body: low across the abdomen within the underwear line after a tummy tuck, along the inner upper arm after an arm lift, and small entry points after liposuction, which fade over 12–18 months.

Can you lower the risk of a poor scar before surgery?

• Stop all nicotine at least 4–6 weeks before surgery: in smokers, poor healing and thick or prominent scars are more likely.
• Mention any raised scars or keloids you have had before, and where they formed.
• Accept the incision your anatomy needs. For a breast lift, ASPS advises choosing the pattern your breasts require rather than insisting on the smallest scar.
• Plan sun protection for the area, and clothing that will not rub it once you are home.

How should you look after the wound in the first weeks?

• Keep dressings clean and follow the cleaning instructions you are given. Covering dressings and a wound ointment help keep a healing scar soft.
• Avoid stretching, rubbing or pressing on the incision. After a tummy tuck, for example, you walk slightly bent at first to protect the stitches.
• Stay off all nicotine: smoking makes poor healing, skin loss and thick or prominent scars more likely.
• Avoid sunbathing, swimming pools and the sea until your surgeon confirms the wound has healed.
• Wear clothing that does not rub the area.

Do silicone gel and sheets really help?

Silicone is part of most aftercare plans once a wound has closed, and it has more evidence behind it than other scar creams. A Cochrane review found some improvement in scar thickness and colour with silicone sheeting, but the studies were of low quality, and the evidence that silicone prevents poor scars is weak.

Start only when your surgeon confirms the wound has healed, often from around the second week. Gel or sheets are worn 12–24 hours a day, usually for several months.

Ask Dr. İlker a question

How long should you protect a scar from the sun?

Usually for the first year, and longer for some scars. Face, neck and ear scars are typically protected for 12 months, and body lift scars for 18–24 months while they mature. After a scar revision, Op. Dr. Bilgehan İlker advises at least 6 months.

Once the wound has healed, use SPF 30+ on any scar the sun can reach, keep it covered when you can, and avoid sunbeds during the first year.

Do scar massage and creams help?

Gentle massage is part of some aftercare plans, for example after a breast lift or reduction, but only once the wound has healed and your surgeon allows it.

Other products, such as onion extract, show promising but limited results. No cream changes a scar's width or position; for that, injections, laser or surgery are needed, often in combination.

Why do some people scar more than others?

Skin type, location and direction all matter. People with darker skin, or very fair, freckled skin and red hair, are more prone to raised scars and keloids. Scars on the mid-chest and shoulders tend to heal worse, while the face and neck usually heal well, and scars that follow the skin's natural tension lines heal better than those running across them.

A raised (hypertrophic) scar is red, raised and itchy, and often flattens and fades over a few months. A keloid is larger and keeps growing beyond the edges of the original wound. Some operations carry a measurable risk too: in a 2022 review of arm lifts, about 1 in 10 people had abnormal scarring.

When can a scar be treated?

Early, if it is thickening. For a wide, raised scar, Op. Dr. Bilgehan İlker may try steroid injections in the first weeks, and these are usually repeated every 4–6 weeks, often alongside silicone or pressure.

Later, if it is wide, sunken, discoloured or tight once mature. Because most scars need 12–18 months to mature, surgical revision is usually considered after about a year, and laser or RF microneedling after 12–18 months. Revision makes a scar flatter, narrower or better placed; it cannot erase it.