Dr Scott J Turner | Specialist Plastic Surgeon (FRACS) | Sydney
Scarring is one of the most common patient concerns about breast augmentation, and that’s understandable. Even though augmentation scars are smaller than scars from breast lift or breast reduction, they’re still permanent, and how they settle over the following 12 to 18 months matters. The good news is that scar quality is partly within your control. Surgical technique sets the starting point, but what you do during recovery has a meaningful impact on what the scar looks like at 12 months and beyond.
Dr Scott J Turner is a Specialist Plastic Surgeon (FRACS) with over a decade in private practice. He has performed more than 1,000 breast procedures and consults from his Sydney clinics in Bondi Junction and Manly. The article that follows walks through the three incision approaches and what scars from each typically look like, the 12 specific actions that genuinely reduce scarring, and the treatment options available if scars don’t settle the way you’d hoped.
Why Breast Augmentation Scars Are Different
Quick context before going into the 12 actions. BA scars are meaningfully smaller than breast lift or reduction scars. The procedure involves placing an implant through a single incision rather than removing tissue and repositioning the nipple-areola complex. That means one incision per side, typically 4 to 5 cm long, in a location chosen specifically to minimise long-term visibility.
Three incision approaches are used in modern breast augmentation:
Inframammary fold, hidden in the natural crease beneath the breast. The most common approach in contemporary practice. The scar sits where the breast tissue itself covers it in standing posture, which means it’s typically not visible in everyday life or swimwear.
Periareolar, around the lower border of the areola at the natural pigment transition. The scar tends to fade well into the pigment border but can interfere with sensation and breastfeeding capacity slightly more than the other approaches.
Trans-axillary, in the armpit. The scar is genuinely hidden but the technique has fallen out of favour for several reasons (limited surgical access, higher revision rates, pocket positioning challenges). Used relatively rarely in modern practice.
Most patients heal with BA scars that fade meaningfully and become difficult to spot at 12 to 18 months. A smaller proportion develop more visible scars. The 12 actions below are aimed at giving you the best chance of being in the first group rather than the second.
The 12 Proven Ways to Minimise Scars
1. Choose Your Surgeon Carefully
The single biggest factor in scar quality isn’t anything you do at home. It’s the surgical technique used in theatre. A surgeon who closes wounds with appropriate tension, uses layered absorbable sutures, places incisions in optimal positions, and pays attention to scar care protocols sets the foundation for everything that follows.
What to look for:
- Specialist Plastic Surgeon (FRACS) qualification verified through AHPRA
- High volume of breast procedures (Dr Turner has performed over 1,000)
- Detailed discussion of incision options and scar implications at consultation
- Defined post-operative scar care protocol included in the surgical plan
- Hospitals accredited for cosmetic surgery rather than office-based facilities
The right surgical technique can produce a fine line scar that fades to barely visible. The wrong technique can produce a wider, more pigmented scar that no amount of post-operative care will fully correct.
2. Stop Smoking and Vaping Six Weeks Before Surgery
Nicotine constricts the small blood vessels that supply healing tissue. Smokers and vapers have meaningfully higher rates of wound healing complications, infection, and worse scar quality. The cessation needs to be genuine and sustained for at least six weeks before surgery and six weeks after.
What I tell patients in clinic: this isn’t optional. If you can’t commit to genuine cessation, the surgery should be deferred until you can. The scar quality difference between smokers and non-smokers is substantial enough that doing the surgery without cessation undermines the result you’re paying for.
3. Optimise Your Health Before Surgery
Several factors affect healing capacity. Things worth getting in order before surgery:
- Stable weight (significant fluctuation during healing affects scar maturation)
- Well-controlled chronic conditions (diabetes, autoimmune disease, anything affecting wound healing)
- Adequate protein intake (tissue repair needs protein)
- Hydration
- Stress management (chronic high stress impairs healing)
- Adequate sleep
None of these are dramatic interventions. Cumulatively, they make a difference in how the body handles the healing process.
4. Follow Pre-Operative Instructions Exactly
Pre-op instructions exist because they affect outcomes, not because they’re administrative. Common pre-op requirements include:
- Stopping certain medications (aspirin, ibuprofen, fish oil, vitamin E, certain herbal supplements)
- No alcohol for 48 hours before surgery
- Specific shower protocols with antibacterial wash
- Fasting requirements for anaesthesia
- Skin preparation
Skipping or modifying these instructions can affect bleeding, infection risk, and scar quality. The instructions are designed to give you the best healing platform possible.
5. Wear the Surgical Bra as Instructed
The surgical bra applies compression that supports the healing tissue and reduces tension on the incision lines. Wearing it 24/7 for the first 2 to 3 weeks (removed only briefly for showering after day 3) is essential, not optional.
Patients who skip the bra to be more comfortable in early recovery often regret it later when scars have stretched or become wider than they would have. Short-term comfort isn’t worth the long-term scar impact. For more detail see the support garments article.
6. Avoid Tension on the Incisions
Tension on healing wounds widens scars. The first 6 to 8 weeks are when the healing scaffold is forming, and any tension during this period gets baked into the final scar shape.
Things to avoid:
- Lifting anything heavier than a kettle for the first 2 weeks
- Reaching overhead repeatedly
- Push-ups, planks, or any chest-engaging exercise until cleared at 8 weeks
- Sleeping on your stomach until cleared at 8 weeks
- Any movement that pulls or stretches the chest area
For specific exercise timing, see the exercise after breast augmentation guide.
7. Start Silicone Scar Therapy at 3 Weeks
Silicone gel or silicone sheets applied directly to scars are the single most evidence-based intervention for improving scar quality. Silicone hydrates the scar, reduces collagen overproduction, and encourages a flatter, less pigmented final result.
Start at 3 weeks post-operative once the wound is fully closed and approved by your surgeon. Continue daily for 12 months.
How to use it:
- Gel: thin layer twice daily, allow to dry
- Sheets: wear 12 to 23 hours per day, remove only briefly for hygiene
Both formats work equally well. Consistency matters more than which format you choose. The 3 to 4 week follow-up is where I confirm wounds are ready and clear you to start.
8. Protect Your Scars from Sun Exposure
UV exposure during the first 12 months drives hyperpigmentation that can become permanent. Cover scars with clothing where possible, or use SPF 50+ sunscreen on any scar that may be exposed.
Incidental exposure counts. Low-cut tops on a sunny day, brief uncovered moments at the beach, even time spent driving with the sun coming through a window, these add up over months. The default rule is just to cover the scars whenever you’ll have sun exposure.
9. Use Gentle Scar Massage from Week 6
Once the wound is fully healed and you’ve been cleared at follow-up, gentle scar massage can soften firmer scar tissue and reduce adhesions. The technique is circular pressure with the fingertip, applied directly over the scar, several minutes per scar, two to three times daily.
The surgical team will demonstrate the technique at the 4 to 6 week follow-up. Don’t start massage on your own before being cleared, too early can disrupt healing and actually worsen scar quality.
10. Maintain Healthy Lifestyle Through the First Year
The first 12 months of scar maturation benefit from:
- Continued non-smoking
- Stable weight (don’t undertake significant weight loss during this period)
- Adequate protein intake
- Hydration
- No excessive alcohol (which impairs collagen synthesis)
- Adequate sleep
None dramatic. Cumulatively meaningful for how scars settle.
11. Attend All Follow-Up Appointments
Follow-up appointments at 1 week, 3 weeks, 1 month, 3 months, 6 months, and 12 months let any concerns be picked up early. A scar showing early signs of becoming hypertrophic responds much better to intervention at 3 months than at 12 months. Catching issues early means simpler treatment.
If you can’t make a scheduled follow-up, reschedule rather than skip it. The cadence of follow-up is designed around the phases of scar maturation, and missing one means a longer gap until the next opportunity to assess progress.
12. Address Any Scar Concerns Early Rather Than Waiting
If something doesn’t look right, raise it at follow-up rather than waiting to see if it resolves. The most common scar concerns:
- A scar becoming significantly more raised, red, or painful between follow-ups
- Sudden swelling or discharge from a previously healed scar
- Any sign of infection
- Concerns about scar appearance that aren’t resolving as expected
Most concerns are addressable. Earlier review almost always means simpler intervention than waiting until the issue is well-established.
The Three Phases of Scar Healing
Worth understanding the timeline so the actions above land in context.
Phase 1: Wound Healing (Weeks 0 to 3)
The first three weeks are about closing the wound, not caring for the scar. The deep dermal layers are knitting back together, the surface is sealing, and the body is producing the inflammatory mediators that drive healing. The wound is structurally fragile during this period.
Active scar care (silicone, massage) doesn’t start yet. The focus is on protecting the closing wound through compression, tension avoidance, and following dressing instructions.
Phase 2: Active Scar Maturation (Months 1 to 12)
The work happens here. The scar is forming its long-term character, and what you do can genuinely change the outcome. Daily silicone therapy, sun protection, gentle massage from week 6, and lifestyle support all contribute to better scar quality.
The scar progresses through pink, raised, and sometimes itchy at 6 weeks, through pink to red and flatter at 3 months, fading toward lighter colour and mostly flat at 6 months, then pale, flat, and mature by 12 months.
Phase 3: Long-Term Maturation (Months 12 to 18+)
By 12 months, most maturation is done. By 18 months, what you see is essentially what you’ll have long-term. Most patients can stop daily silicone at 12 months. Continued sun protection is sensible.
If your scars haven’t settled well by 18 months, treatment options exist. These are covered in the next section.
Treatment Options When Scars Don’t Settle Well
A small proportion of patients develop scars that don’t follow the normal maturation pattern. Several treatment options are available.
Steroid injection for raised hypertrophic scars. Intralesional triamcinolone can flatten and soften the tissue. Done in clinic, typically 2 to 4 sessions spaced 4 to 6 weeks apart.
Laser treatment for redness or texture. Vascular lasers target redness in immature scars. Fractional lasers target texture issues. Series of sessions, generally.
Scar revision surgery for scars that have healed wide or become problematic. The technique excises the existing scar and re-closes the wound. Generally not considered before 12 to 18 months post-operative.
Combined approaches. Treating problematic scars often means combining options based on the specifics of what’s not working.
Frequently Asked Questions
How long do breast augmentation scars take to fade?
Most BA scars take 12 to 18 months to mature fully. They typically appear pink or red for the first 6 months, then gradually fade to lighter pink and eventually to white or skin-tone by 18 months. Inframammary scars hidden in the breast crease are often difficult to spot once mature. Periareolar scars blend into the natural pigment transition. Final visibility depends on individual healing factors as well as adherence to scar care.
When should I start using silicone scar therapy after breast augmentation?
Start silicone gel or silicone sheets at 3 weeks post-operative, once the wound is fully closed and approved by your surgeon at the follow-up appointment. Continue daily for 12 months. Silicone is the single most evidence-based intervention for scar quality, and consistency matters more than which format (gel or sheet) you choose.
Where will my breast augmentation scar be?
The most common location is the inframammary fold (natural crease beneath the breast), where the scar is hidden by the breast itself in standing posture and by clothing in everyday life. Periareolar (around the lower border of the areola) and trans-axillary (in the armpit) are alternative incision locations chosen based on specific clinical factors. The incision location is discussed in detail at consultation as part of the surgical planning.
Can I prevent hypertrophic or keloid scars after breast augmentation?
You can reduce but not eliminate the risk. Silicone therapy started at 3 weeks and continued for 12 months reduces the likelihood of hypertrophic scarring. Sun protection prevents pigmentation changes. Smoking cessation, stable weight, and tension reduction during early healing all contribute. If you have a personal or family history of keloid formation, mention this at consultation so pre-emptive measures can be planned.
What if my breast augmentation scars don’t fade well?
Several treatment options are available, including steroid injection for hypertrophic scars, laser treatment for redness or texture, and scar revision surgery for problematic cases. The choice depends on what specifically isn’t right about the scar. Treatment is usually more effective when started before scars are fully mature, so raising concerns at follow-up appointments rather than waiting allows earlier and simpler intervention.
Consult with Dr Scott J Turner in Sydney
Dr Scott J Turner is a Specialist Plastic Surgeon (FRACS) consulting at his Bondi Junction and Manly clinics in Sydney. Surgery is performed at accredited private hospitals in Sydney, including Bondi Junction Private Hospital, Delmar Private Hospital in Dee Why, and East Sydney Private Hospital.
Every consultation is conducted personally by Dr Turner. There are no patient representatives or coordinators standing in for the surgeon. A minimum of two consultations is required before any surgery is booked, in line with AHPRA requirements. The scar conversation gets real time at consultation, including incision location options, scar care protocols, and honest discussion of what to realistically expect from breast augmentation scars in your specific situation.
If you’re considering breast augmentation surgery, the next step is to obtain a GP referral and book an initial consultation. Contact the practice on [email protected] or via the contact page to begin the process. For more detail on the procedure itself, see the breast augmentation page, the Breast Augmentation Sydney 2026 Guide, and the recovery guide.
