Breast Surgery Scars: Where They Sit, How They Heal & How to Improve Them

Where are the scars after breast surgery?

Breast surgery scars sit where the incisions are made: in the fold under the breast, around the areola, in the armpit, vertically down the lower breast, or across the chest after mastectomy, and surgeons place them where they are least visible.

Every operation that goes through the skin leaves a scar. What changes from one procedure to another is the length of the scar and its position. The table below gives a general overview; your own scar pattern depends on your anatomy and the technique your surgeon recommends.

For breast augmentation, the incision is commonly made in the inframammary fold (the crease under the breast), around the lower edge of the areola, or in the armpit. Each has advantages: a fold scar gives the surgeon good access and is usually hidden under the breast; an areola scar sits at the natural colour change; an armpit scar keeps the breast itself free of scars. Read more about the options on our breast augmentation page.

What scars does a breast lift or breast reduction leave?

A breast lift or breast reduction usually leaves a scar around the areola, often a vertical scar from the areola to the fold (a “lollipop”), and sometimes a horizontal scar in the fold, creating an anchor shape.

Because these operations remove skin, and in reduction also breast tissue, the scars are longer than after augmentation. The main patterns are:

• Periareolar (around the areola) — for small lifts; the scar sits at the edge of the areola.
• Vertical or “lollipop” — around the areola and straight down to the fold; common for moderate lifts and reductions.
• Wise pattern or “anchor” — adds a horizontal scar along the fold; used for larger reductions and heavier, lower breasts.

The vertical scar and the ends of the fold scar are usually the most noticeable parts in the first year, as these areas are under the most tension. The areola scar often becomes very discreet because it sits on the border between two colours of skin. You can compare these options on our breast lift and breast reduction pages.

What scars do mastectomy and breast reconstruction leave?

A traditional mastectomy leaves a horizontal or slightly diagonal scar across the chest, while skin-sparing and nipple-sparing mastectomy can place shorter scars around the areola, in the breast fold or on the side of the breast.

The type of mastectomy, and therefore the scar, is decided first by the breast surgeon and the oncology team for safe cancer treatment. When reconstruction is planned at the same time, the breast surgeon and plastic surgeon can often agree incisions that preserve more skin and give a better final shape.

Reconstruction adds its own scars:

• Implant reconstruction usually uses the mastectomy scar, so no extra scar is created on the breast.
• DIEP and other abdominal flaps leave a hip-to-hip scar on the lower abdomen, similar to a tummy tuck, and a scar around the transferred skin “island” on the breast.
• Latissimus dorsi flap leaves a scar on the back, which can often be placed in the bra line.
• Nipple reconstruction adds very small scars on the new nipple mound.

If you are living with a mastectomy scar and considering reconstruction, our after mastectomy guide explains the options and how existing scars are taken into account.

How long do breast surgery scars take to fade?

Breast surgery scars usually look their reddest and firmest at around 6–12 weeks, then gradually flatten, soften and fade over 12–18 months, and sometimes up to two years.

Scar healing happens in stages:

1. First 2–3 weeks — the wound closes and the skin edges knit together. The scar is a fine line, sometimes with slight bruising.
2. Weeks 3 to about 3 months — the body lays down collagen to strengthen the wound. The scar often becomes pink or red, slightly raised and firm, and may itch. This is normal and is the stage that worries many patients.
3. 3 to 18 months — the scar matures. Collagen is remodelled, the colour fades towards a pale or slightly darker line, and the scar becomes flatter and softer.

A scar is described as mature when it is flat, soft and no longer pink. Because this takes so long, surgeons usually advise waiting at least 12 months before judging the final result or considering a scar revision. A scar never disappears completely, but in many patients it becomes a fine, pale line that is hard to notice.

How should you care for breast surgery scars?

Good scar care means keeping the wound clean until it has healed, then using silicone gel or sheets, protecting the scar from sun, avoiding tension, and, once advised by your surgeon, gentle massage.

The evidence is strongest for silicone and for reducing tension. A practical routine many surgeons recommend is:

• Wait until the wound is fully closed, with no scabs or open areas, usually around 2–3 weeks. Follow your surgeon’s instructions on dressings and showering until then.
• Silicone gel or silicone sheets — applied daily for at least 2–3 months, and often longer. They keep the scar hydrated and may reduce redness, thickening and itch.
• Taping — paper tape or special scar tape across or along the scar in the early weeks can reduce the stretching forces that make scars widen.
• Supportive bra — wear the post-operative or sports bra as advised; it takes weight off the scars under the breast.
• Massage — once your surgeon agrees, usually from about 4–6 weeks, firm circular massage with a plain moisturiser for a few minutes a day can soften the scar.
• Sun protection — UV light can darken healing scars, sometimes permanently. Cover them or use a high-factor sunscreen (SPF 30–50) for at least the first year.
• No smoking — smoking reduces blood flow to healing skin and increases the risk of wound breakdown and poor scars.

Avoid heavy lifting and strenuous upper-body exercise for the period your surgeon advises, usually several weeks, because tension on fresh scars can widen them.

What is the difference between a hypertrophic scar and a keloid?

A hypertrophic scar is raised, red and thick but stays within the line of the original incision and often improves over time, while a keloid grows beyond the scar’s edges into the surrounding skin and rarely goes away on its own.

Both are caused by an overactive healing response that produces too much collagen.

• Hypertrophic scars are relatively common after breast surgery, especially at the vertical part of a lift or reduction scar and at the ends of the fold scar, where tension is highest. They usually appear in the first few months and often soften within 12–24 months, particularly with treatment.
• Keloids are less common. They can be itchy or painful, may keep growing slowly and can come back after being cut out. They are more frequent on the chest and breastbone area, in people with a personal or family history of keloids, and in people with darker skin.

If you have had keloids before, for example after ear piercing, acne or previous surgery, tell your surgeon before the operation. The incision plan, closure technique and early preventive treatment can all be adapted.

How are raised, wide or painful breast scars treated?

Raised or thick breast scars are usually treated with silicone and pressure first, then steroid injections, laser treatment or, once the scar is mature, scar revision surgery; keloids often need a combination of treatments.

The options include:

• Steroid injections — a corticosteroid (often triamcinolone) injected into the scar every 4–6 weeks can flatten and soften raised scars and relieve itching. Side effects can include thinning or lightening of the skin.
• Laser and light treatments — vascular lasers can reduce redness; fractional lasers can improve texture and thickness. Several sessions are usually needed.
• Other injections — for stubborn scars, specialists sometimes combine steroids with other medicines such as 5-fluorouracil.
• Scar revision surgery — cutting out a wide or stretched scar and closing it again carefully, usually no sooner than 12 months after the original operation. It cannot remove a scar, but it can make it finer or move it to a better position.
• Fat grafting — injecting a small amount of your own fat under tight, tethered or depressed scars can release them and improve the skin quality.
• Keloid management — surgical removal of a keloid on its own has a high recurrence rate, so it is generally combined with steroid injections, pressure or, in selected cases, low-dose radiotherapy.

A scar that is wide, uneven or asymmetric between the two sides can sometimes be improved as part of a wider revision and symmetry procedure. More about using your own fat is on our fat grafting page.

Do breast surgery scars look different on darker skin?

On darker skin, breast scars are more likely to become darker than the surrounding skin (hyperpigmentation) and to become raised, and keloids are more common, so prevention and early treatment are especially important.

People with brown or black skin often find that scars stay darker for longer, though many fade gradually over one to two years. Redness may show as purple or dark brown rather than pink. Practical points include:

• Discussing your scar history and any keloids in the family before surgery.
• Strict sun protection, as UV light makes post-inflammatory darkening worse.
• Starting silicone early and reviewing the scar regularly, so that any thickening can be treated with injections before it becomes established.
• Choosing laser types and settings with care, because some lasers can lighten or darken darker skin; treatment should be done by someone experienced with your skin type.

Darker skin is not a reason to avoid breast surgery, but scar risk should be part of the planning conversation, including the choice of incision.

How does radiotherapy affect breast scars?

Radiotherapy can make breast scars and the surrounding skin firmer, tighter, darker and less elastic, and it can slow healing, which is why surgery on radiated skin needs particular planning.

After radiotherapy for breast cancer, the skin may show long-term changes: thickening, dryness, colour change, small visible blood vessels and tightening (fibrosis) of the tissues beneath. A lumpectomy scar may become pulled in, creating a dent or a change in breast shape, and the breast may sit higher or look smaller than the other side.

These changes affect scar options in several ways:

• Scars on irradiated skin tend to be less stretchy and can heal more slowly if operated on.
• Implant-only reconstruction carries a higher risk of complications and tight capsules after radiotherapy, so flap reconstruction or fat grafting is often preferred.
• Fat grafting can soften radiated scars and improve skin quality in many patients.

Our page on reconstruction after radiotherapy explains how timing and technique are adapted.

Can areola tattooing hide breast scars?

Yes, medical areola and nipple tattooing can recreate the colour of an areola after reconstruction and can camouflage scars around the areola, often making them much less noticeable.

Tattooing uses pigments matched to the other breast or to a natural skin tone. Skilled 3D techniques add shading that gives the illusion of a projecting nipple on a flat surface. It is commonly used:

• After breast reconstruction, either alone or on top of a surgically reconstructed nipple.
• To blend a pale or uneven scar around the areola after a lift, reduction or augmentation.
• To even out the colour or shape of an areola that has become irregular after surgery.

Tattooing is usually done once the scars have matured, several months after surgery, and may need a touch-up over time as pigment fades. It is not suitable over scars that are still red or raised, and results can be less predictable on irradiated skin. Read more on nipple and areola reconstruction.

How can a plastic surgeon help with breast surgery scars?

A plastic surgeon can help by planning incisions to minimise scarring before surgery, guiding scar care afterwards, and treating scars that are raised, wide, tethered or asymmetric once they have matured.

Scars are part of any breast operation, but how they are planned and managed makes a real difference. A consultation about scars usually covers:

• Which incision options suit your breasts and the procedure, and what scar you can realistically expect.
• Your personal risk factors: previous scars, keloids, skin type, smoking, radiotherapy and general health.
• A scar-care plan for the first year.
• For existing scars, whether non-surgical treatment, fat grafting, revision or tattooing is most likely to help, and what the limits are.

Dr. Fatih Kılıç, a plastic, reconstructive and aesthetic surgeon, can review photographs of established scars and advise on options. Scars that are still changing are usually best assessed after a year. Any new lump, ulcer or change in an old scar after breast cancer treatment should first be checked by your breast team, as described in life after breast cancer.

Scar advice for patients in Germany, Bulgaria and the UK

If you live in Germany or Bulgaria (or the UK) and are unhappy with a scar after breast augmentation, lift, reduction, mastectomy or reconstruction, you can share clear photographs and your operation reports online for an opinion from Dr. Fatih Kılıç on whether silicone treatment, injections, fat grafting, scar revision or tattooing might help, and when the timing is right. Istanbul is about 1 hour 15 minutes by air from Sofia and about 3 hours from major German airports. Early scar problems such as an open wound, discharge or redness with fever should be seen by your own surgeon or doctor first. After any consultation you receive a written summary to share with your doctor at home. See international patients or contact us.

Frequently asked questions

Medically reviewed by Dr. Fatih Kılıç, Plastic, Reconstructive and Aesthetic Surgeon. This page is for general information and does not replace an individual consultation.