Breast Augmentation Scars: What to Expect and How They Heal

If considering breast augmentation surgery, questions about scarring often come up early in the decision process. Every surgical procedure leaves some form of scar, and breast augmentation is no exception. The extent, location, and appearance of scarring depend on the incision site chosen, individual healing characteristics, and the aftercare followed during recovery. This article explains what a patient can expect from breast augmentation scars, how they change over time, and the practical steps that support the healing process.

Why Scarring Is Part of Breast Augmentation Surgery

Breast augmentation involves placing an implant into a pocket created within the breast tissue. To create this pocket and insert the implant, a small incision must be made in the skin. Once the implant is positioned, the incision is closed with sutures. As the skin heals, the body forms scar tissue at the site of the incision. This scarring is a normal part of wound healing rather than a sign that anything has gone wrong.

The initial scar appearance immediately after surgery does not represent the final outcome. A scar that looks red, raised, and prominent in the first months following surgery will typically fade and flatten substantially over the following year. Scar maturation continues for up to 18 months after surgery, and the appearance of a patient’s scars will change significantly during this period.

The Main Incision Sites and Their Scars

There are three main incision options used in breast augmentation surgery. Each has different implications for scar location, visibility, and long-term appearance.

Inframammary Incision (Under the Breast Fold)

The inframammary incision is placed within the natural crease under the breast, where the breast tissue meets the chest wall. This is the most commonly used approach in breast augmentation because it gives the surgeon direct access to the implant pocket, allows precise implant placement, and hides the resulting scar within the breast crease itself.

The scar is typically 4 to 5 centimetres in length and sits low on the breast within the fold. When standing upright or wearing normal clothing, including swimwear, the scar is generally not visible. It only becomes visible when the breast is lifted or when a patient is lying flat on their back. For most patients, this position offers a good balance of surgical access and long-term scar concealment.

Periareolar Incision (Around the Nipple)

The periareolar incision is placed at the border where the pigmented areola meets the surrounding breast skin. This incision follows the lower half of the circumference of the areola, and the resulting scar can blend into the natural pigmentation transition between areola and breast skin.

The trade-off with periareolar incisions is that they pass through the breast tissue during implant placement, which has been associated with slightly higher rates of altered nipple sensation and difficulty breastfeeding in some studies. This incision is also not suitable for patients with small areolas, as the incision length is limited by the size of the areola border.

Transaxillary Incision (Underarm)

The transaxillary incision is placed within a natural crease in the armpit, and the implant is inserted through a tunnel created between the underarm and the breast pocket. The advantage is that no scar is placed on the breast itself. The trade-off is that the technique is more demanding surgically, usually requires an endoscope for precise implant placement, and produces a scar in the underarm that may be visible in sleeveless clothing.

Dr Terrence Scamp will discuss which incision approach suits a patient’s anatomy, the implant chosen, and their preferences during a consultation.

How Breast Augmentation Scars Change Over Time

Scars go through a predictable pattern of change during the months following surgery. Understanding this timeline can help set realistic expectations at each stage of recovery.

The First Two Weeks

Immediately after surgery, the incision sites are held together by sutures and covered by dressings. The area around the incision is often swollen, bruised, and tender. This is the inflammatory phase of wound healing, when the body is closing the wound and preventing infection.

Weeks Two to Six

Sutures are typically removed or dissolve during this period. The scar begins to appear pink or red and slightly raised, and it may feel firm to the touch. This is the proliferative phase, when the body is laying down new collagen to rebuild the skin at the wound site. It is normal for scars to look worse before they look better during this stage.

Months Three to Six

The scar continues to fade in colour and gradually flatten. Firmness begins to decrease as the collagen structure remodels. Many patients notice a marked improvement in scar appearance during this period. This is the beginning of the maturation phase.

Twelve to Eighteen Months

Full scar maturation typically occurs at around 12 to 18 months after surgery. By this point, the scar has usually faded to a colour close to the surrounding skin, has flattened significantly, and has softened. The final appearance is generally clearer at 18 months and does not change substantially after this.

What a Mature Breast Augmentation Scar Looks Like

A well-healed breast augmentation scar in a typical patient is a fine line that has faded to a colour close to the surrounding skin. It is usually flat or slightly indented rather than raised, and it feels similar in texture to the surrounding skin. In good lighting or when the skin is stretched, the scar may still be visible on close inspection, but it does not stand out at normal viewing distance in most patients.

Individual outcomes vary significantly. Some patients heal with scars that are almost invisible at maturity. Others develop scars that remain more visible or textured despite following aftercare instructions carefully. This variation is largely genetic and cannot always be predicted before surgery.

Factors That Affect How a Patient’s Breast Augmentation Scars Heal

Several factors influence how well scars heal and how they look at maturity. Some of these can be controlled during the recovery period, and others cannot.

Genetics

Individual genetics play a significant role in scar formation. Some people naturally form fine, well-hidden scars, while others form scars that are more prominent, raised, or discoloured. A family history of raised or keloid scarring can indicate a higher likelihood of similar patterns in a patient’s own healing.

Skin Type

Skin type affects both the way scars heal and the way they look. People with darker skin tones can be more prone to hyperpigmentation or keloid formation. People with very fair skin may see scars remain pink or red for longer before fading. Neither pattern indicates that anything has gone wrong, though it does affect the appearance of the scar during healing.

Age

Younger skin tends to heal with more vigorous collagen production, which can produce more prominent scars. Older skin heals more slowly but often produces scars that appear less prominent at maturity.

Smoking

Smoking significantly impairs wound healing by reducing blood supply to the skin and slowing collagen production. Patients who smoke are more likely to experience delayed healing, wound complications, and poorer scar appearance. Dr Scamp requires patients to stop smoking well before and after surgery to reduce these risks.

Sun Exposure

Ultraviolet exposure during the first 12 months after surgery can cause scars to darken permanently through hyperpigmentation. Protecting scars from sun exposure during this period is one of the more important controllable factors in scar appearance.

Wound Tension

Scars that heal under tension are more likely to widen or become raised. Wearing the surgical support garment as directed and avoiding movements that stress the incision site during early healing reduces wound tension and supports better scar formation. 

Scar Management Techniques That May Help

Several practical steps during the recovery period may support better scar healing. Dr Scamp will provide specific guidance based on the patient’s individual healing, but the common measures used in breast augmentation aftercare include the following.

Silicone Gel and Silicone Sheeting

Silicone-based scar management products are among the more evidence-supported measures for improving scar appearance. Silicone gel or silicone sheets are typically applied to the scar starting around two weeks after surgery (once the incision has fully closed) and continued for several months. Silicone appears to hydrate the scar tissue and modulate collagen production, which can improve final appearance.

Compression and Support

Wearing a surgical bra or support garment as directed reduces tension on the incision site during early healing. This helps prevent wound stretching that can lead to wider or more prominent scars.

Sun Protection

Sun protection over the scar is important for at least 12 months after surgery. Once the incision is healed, a high-SPF sunscreen should be applied to the scar whenever it may be exposed to sun. During the first weeks after surgery, the area should be kept covered entirely. 

Gentle Massage

Once the incision has fully healed and Dr Scamp has advised it is safe to begin (usually from around 6 weeks), gentle massage of the scar with an unscented moisturiser may help soften the scar tissue and improve mobility. The scar should not be massaged before it has fully closed, as this can disrupt healing. 

What to Avoid

Patients should avoid picking at scabs, pulling on the incision site, or applying strong active skincare ingredients (such as retinoids or acid exfoliants) to the scar area during healing. Tanning beds, prolonged sun exposure, and smoking should also be avoided during the recovery period. 

When Scars Do Not Heal as Expected

In some cases, breast augmentation scars heal in ways that require additional attention. The two most common patterns are hypertrophic scars and keloid scars.

Hypertrophic Scars

A hypertrophic scar is one that stays raised and red for longer than expected, though it remains within the boundaries of the original incision. These scars can improve with time and with active management. If a patient develops a hypertrophic scar, they can discuss management options with Dr Scamp at their follow-up appointments.

Keloid Scars

Keloid scars are raised, thickened scars that extend beyond the boundaries of the original wound. They are more common in people with a genetic predisposition or darker skin tones. Keloids can be more difficult to manage. Options may include corticosteroid injections, silicone therapy, or in some cases surgical revision. Dr Scamp can discuss the appropriate options if this applies to the patient’s case.

If the patient has a personal or family history of keloid scarring, they must mention this at their initial consultation. It affects the discussion of risks and may influence the surgical plan.

Can Breast Augmentation Scars Be Revised?

If a scar heals poorly and does not improve with time and conservative management, scar revision surgery is an option in some cases. Scar revision involves excising the poorly healed scar and re-closing the wound using techniques designed to produce a better scar the second time around.

Scar revision is not typically considered until the original scar has fully matured, which takes at least 12 to 18 months after the original surgery. This gives the scar the maximum opportunity to improve on its own before further surgery is considered.

Not every scar is a good candidate for revision. In some cases, particularly with keloid tendencies, revision surgery can produce scarring that is no better than the original. Dr Scamp will discuss whether revision may be appropriate in the individual patient’s case and what to realistically expect.

How to Reduce Scar Visibility from the Start

The most effective scar management begins before surgery, with the surgical planning itself. The choice of incision site is one of the most important decisions in this respect. Careful surgical technique, meticulous wound closure, and thorough aftercare instructions all contribute to producing the best scar outcome achievable for the patient’s individual healing.

At a consultation, Dr Scamp will:

• Assess the patient’s skin type and healing characteristics
• Ask about the patient’s family history of scarring
• Discuss the incision options and where each scar would sit for their anatomy
• Explain the aftercare that supports scar healing
• Set realistic expectations about what the patient’s scars are likely to look like at maturity

Learn More About Breast Augmentation with Dr Terrence Scamp

Dr Terrence Scamp is an AHPRA-registered specialist plastic surgeon (MED0001157212) providing breast augmentation consultations on the Gold Coast. He is a Fellow of the Royal Australasian College of Surgeons (FRACS) with specialist training in plastic and reconstructive surgery.

All consultations are held at 95 Upton Street, Bundall. Breast augmentation surgery is performed under general anaesthesia at Pacific Private Hospital in Southport. A GP referral is required before consultation, and a minimum 7-day cooling-off period applies between consultation and surgery under Australian guidelines for cosmetic surgery.

Learn more about the breast augmentation procedure or contact the practice to arrange a consultation.