Dr Scott J Turner | Specialist Plastic Surgeon (FRACS)
Key Takeaways
- Breast augmentation scars are a single short incision per side, typically 4 to 5cm, placed in one of three locations chosen to minimise long-term visibility.
- Scar quality is partly within your control. Surgical technique sets the starting point, but what you do during the 12 to 18 month healing window has a meaningful effect on the result.
- Silicone therapy is the topical intervention most consistently supported in the scar literature. It starts at three weeks once the wound is fully closed and continues daily for around twelve months.
- Sun protection, avoiding tension on the incisions, wearing the surgical bra as instructed, and complete smoking cessation each contribute measurably.
- Most breast augmentation scars fade to become difficult to spot by 12 to 18 months. A smaller proportion need treatment such as steroid injection, laser, or scar revision.
- Raising a scar concern early, at a scheduled follow-up, almost always means simpler treatment than waiting to see whether it resolves.
Scarring is one of the most common concerns raised about breast augmentation, and that is understandable. Breast augmentation scars are short and carefully placed, but they are permanent, and how they settle over the following 12 to 18 months matters to most patients more than how they look in the first few weeks. The encouraging part is that scar quality is partly within your control. Surgical technique sets the starting point, but what you do during recovery has a real influence on what the scar looks like at twelve months and beyond.
This guide covers the three incision approaches and what scars from each typically look like, twelve specific actions that reduce scarring, the phases scar tissue moves through, and the treatment options available if a scar does not settle the way you hoped. For an overview of the operation itself, see the breast augmentation surgery page. If you are researching a different breast procedure, breast lift scars follow a different pattern and are covered separately.
What breast augmentation scars look like
Breast augmentation places an implant through a single incision rather than removing tissue or repositioning the nipple-areola complex. That means one scar per side, typically 4 to 5cm long, sited in a position chosen to keep it as inconspicuous as possible once mature.
Three incision approaches are used in contemporary practice. The inframammary approach sits in the natural crease beneath the breast and is the most commonly used. The scar falls where breast tissue covers it in standing posture, so it is generally not visible in everyday clothing or swimwear. The periareolar approach runs along the lower border of the areola at the natural pigment transition, where the scar tends to blend into that border as it fades, though this route carries a slightly higher influence on nipple sensation and breastfeeding capacity than the alternatives. The trans-axillary approach places the scar in the armpit and keeps it off the breast entirely, but it has fallen out of routine use for several reasons including restricted surgical access, higher revision rates, and difficulty controlling implant pocket position. It is now used relatively rarely.
Which approach suits you depends on your anatomy, the implant chosen, and your own priorities, and it is a decision made together at consultation rather than a fixed default.
Most patients heal with scars that fade substantially and become difficult to spot at 12 to 18 months. A smaller proportion develop scars that stay more visible. Healing capacity varies between individuals and cannot be fully predicted in advance, but the twelve actions below give you the best chance of landing in the first group.
The 12 ways to minimise breast augmentation scars
1. Choose your surgeon carefully
The single biggest influence on scar quality is not anything done at home. It is the technique used in theatre. A surgeon who closes wounds without undue tension, uses layered absorbable sutures, sites incisions thoughtfully, and works to a defined scar-care protocol sets the foundation for everything that follows.
What to look for: a Specialist Plastic Surgeon (FRACS) qualification you have verified directly through the AHPRA register, a detailed discussion of incision options and their scar implications at consultation, a written post-operative scar-care protocol forming part of the surgical plan, and surgery performed in accredited hospital facilities rather than office-based rooms.
Appropriate technique can produce a fine-line scar that fades to barely perceptible. Technique that places the closure under tension 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 supplying healing tissue. Smokers and vapers have meaningfully higher rates of wound-healing complications, infection, and poorer scar quality. Cessation needs to be complete and sustained for at least six weeks before surgery and six weeks afterwards.
This one is not negotiable. If you cannot commit to full cessation across that window, surgery is better deferred until you can, because operating without it undermines the result you are paying for.
3. Optimise your health before surgery
Several general factors affect healing capacity and are worth getting in order beforehand. A stable weight matters, since significant fluctuation during the healing window affects how scars mature. Well-controlled chronic conditions such as diabetes or autoimmune disease, adequate protein intake for tissue repair, good hydration, managed stress levels, and sufficient sleep all contribute.
None of these are dramatic interventions on their own. Cumulatively they change how well the body handles a healing wound.
4. Follow pre-operative instructions exactly
Pre-operative instructions exist because they affect outcomes. Typical requirements include ceasing certain medications and supplements such as aspirin, ibuprofen, fish oil, vitamin E and some herbal preparations, avoiding alcohol for 48 hours beforehand, following specific antibacterial shower protocols, fasting for anaesthesia, and preparing the skin as directed.
Modifying or skipping any of these can affect bleeding, infection risk, and ultimately scar quality. They are designed to hand the surgeon the best possible healing platform.
5. Wear the surgical bra as instructed
The surgical bra applies compression that supports healing tissue and reduces tension across the incision lines. Continuous wear for the first two to three weeks, removed only briefly for showering after day three, is part of the treatment rather than an optional comfort measure.
Patients who abandon it early for comfort often regret it once scars have stretched or widened, and by then the change is difficult to reverse. There is more detail in the support garments guide.
6. Avoid tension on the incisions
Tension across a healing wound widens the resulting scar. The first six to eight weeks, while the collagen scaffold is forming, is the window in which any tension becomes permanently built into the scar’s final shape.
For that period, avoid lifting anything heavier than a full kettle for the first two weeks, repeated overhead reaching, push-ups, planks or any chest-engaging exercise until cleared at around eight weeks, sleeping on your stomach until cleared, and any movement that visibly pulls or stretches the chest. Specific timings are set out in the recovery after breast augmentation guide.
7. Start silicone scar therapy at three weeks
Silicone gel or silicone sheeting applied directly over the scar is the topical intervention most consistently supported in the scar literature. Silicone hydrates the scar, appears to moderate collagen overproduction, and encourages a flatter, less pigmented result.
Start at three weeks post-operatively, once the wound is fully closed and your surgeon has cleared it at follow-up, then continue daily for around twelve months. For gel, apply a thin layer twice daily and let it dry fully. For sheeting, wear it 12 to 23 hours a day, removing it only briefly for hygiene. Both formats perform comparably, and consistency over the full twelve months matters more than which one you pick.
8. Protect your scars from sun exposure
Ultraviolet exposure during the first twelve months drives hyperpigmentation that can become permanent in a scar that would otherwise have faded pale. Cover scars with clothing where you can, and use SPF 50+ on any scar that may be exposed.
Incidental exposure is the part people underestimate. A low-cut top on a bright day, a few uncovered minutes at the beach, time spent driving with sun through the window: these accumulate across months. The workable default is to keep scars covered whenever sun exposure is likely.
9. Use gentle scar massage from week six
Once the wound is fully healed and you have been cleared at follow-up, gentle massage can soften firmer scar tissue and reduce adhesions between the scar and underlying layers.
The technique is circular fingertip pressure applied directly over the scar, a few minutes per scar, two to three times daily. Your surgical team will demonstrate it at the four to six week review. Do not begin massage on your own initiative beforehand, as starting too early can disturb a wound that is still consolidating and worsen the eventual scar.
10. Maintain a healthy lifestyle through the first year
Scar maturation continues for a full twelve months, and it benefits from continued non-smoking, a stable weight with significant intentional weight loss postponed where possible, adequate protein, and moderation with alcohol, which impairs collagen synthesis.
Again, none of this is dramatic. It simply gives the maturing scar a consistent physiological environment to settle into.
11. Attend all follow-up appointments
Follow-up at one week, three weeks, one month, three months, six months and twelve months exists so that developing problems are caught while they are still simple to address. A scar showing early signs of becoming hypertrophic responds considerably better to intervention at three months than at twelve.
If you cannot make a scheduled appointment, reschedule rather than skip it. The cadence is built around the phases of scar maturation, not around administrative convenience.
12. Address any scar concern early rather than waiting
If something does not look right, raise it rather than waiting to see whether it resolves on its own. The concerns worth flagging promptly are a scar becoming noticeably more raised, red or painful between reviews, sudden swelling or discharge from a scar that had already healed, any sign of infection, or an appearance that is not settling along the expected timeline.
Most of these are addressable. Earlier review almost always means simpler intervention than waiting until the problem is well established.
The three phases of scar healing
Understanding the timeline puts the twelve actions above into context.
Phase one, wound healing, weeks 0 to 3. The focus here is closing the wound rather than treating the scar. Deep dermal layers knit together, the surface seals, and the wound remains structurally fragile throughout. Active scar care such as silicone and massage does not begin yet. What matters in this phase is compression, tension avoidance, and following dressing instructions precisely.
Phase two, active scar maturation, months 1 to 12. This is where the work happens and where your input changes the outcome. The scar establishes its long-term character over these months, supported by daily silicone therapy, consistent sun protection, gentle massage from week six, and general healing support. A typical scar progresses from pink, slightly raised and occasionally itchy at six weeks, to pink-red and flatter at three months, to lighter and largely flat at six months, then pale, flat and mature by twelve.
Phase three, long-term maturation, months 12 to 18 and beyond. Most maturation is complete by twelve months, and what you see at eighteen months is essentially the long-term result. Most patients can stop daily silicone at twelve months, though continued sun protection remains sensible. If a scar has not settled acceptably by eighteen months, treatment options are available.
Treatment options when breast augmentation scars do not settle
A small proportion of patients develop scars that do not follow the typical maturation pattern. Several approaches are available and they are often combined.
Steroid injection. Intralesional triamcinolone can flatten and soften a raised hypertrophic scar. It is performed in clinic, typically across two to four sessions spaced four to six weeks apart.
Laser treatment. Vascular lasers target persistent redness in immature scars, while fractional lasers address surface texture. Timing and device selection depend on what specifically is not settling.
Scar revision surgery. A scar that has healed wide or become persistently problematic can be excised and the wound re-closed. This is generally not considered before 12 to 18 months post-operatively, since a scar still actively maturing may yet improve without intervention.
Which combination suits a particular scar depends on the specific problem, and outcomes from scar treatment vary between individuals in the same way that initial healing does.
Frequently asked questions
How long do breast augmentation scars take to fade?
Most take 12 to 18 months to mature fully. They typically appear pink or red for the first six months, then fade gradually to lighter pink and eventually to white or close to skin tone by around eighteen months. Inframammary scars hidden in the breast crease are often difficult to spot once mature, and periareolar scars tend to blend into the pigment border. Final visibility depends on individual healing factors as well as how consistently scar care is followed.
When should I start using silicone scar therapy?
Start silicone gel or sheeting at three weeks post-operatively, once the wound is fully closed and your surgeon has approved it at follow-up, then continue daily for around twelve months. Silicone is the topical intervention with the most consistent supporting evidence, and consistency over the full period matters more than which format you choose.
Where will my breast augmentation scar be?
The most common site is the inframammary fold beneath the breast, where the scar is covered by the breast itself in standing posture and by clothing in daily life. Periareolar placement around the lower areola border and trans-axillary placement in the armpit are alternatives selected on specific clinical grounds. Placement is discussed in detail at consultation as part of surgical planning.
Can I prevent hypertrophic or keloid scars?
You can reduce the risk but not eliminate it. Silicone therapy started at three weeks and continued for twelve months lowers the likelihood of hypertrophic scarring, sun protection prevents pigmentation changes becoming permanent, and smoking cessation, stable weight and tension avoidance during early healing all contribute. If you have a personal or family history of keloid formation, raise it at consultation so that pre-emptive measures can be built into the plan.
What if my breast augmentation scars do not fade well?
Several treatment options exist, including steroid injection for hypertrophic scars, laser treatment for redness or texture, and scar revision surgery in more established cases. The right choice depends on what specifically is not settling. Treatment tends to be more effective when started before a scar is fully mature, which is why raising concerns at a scheduled follow-up rather than waiting allows earlier and simpler intervention.
Dr Scott J Turner is a Specialist Plastic Surgeon (FRACS) consulting in Sydney. A GP referral is required before an initial surgical consultation under the current Medical Board of Australia framework. Individual suitability, incision options, recovery and potential risks are assessed at consultation. To discuss scar-care planning for your situation, contact the practice to arrange an appointment.
