Breast Surgery Scars: Types, Healing Process, and Postoperative Care

One of the aspects that most concerns patients before undergoing breast surgery is the mark the procedure will leave on the skin. Understanding how scars evolve, which factors influence their maturation, and which measures may help improve their appearance is essential to approach the process with realistic expectations. At Mallorca Medical Group, Dr. García Ceballos, FCCP, provides each patient with an individualized assessment that includes detailed information about the planned incisions and the postoperative care protocol.

Why Scars Form in Breast Surgery

Any surgical incision triggers a biological process of tissue repair that culminates in the formation of scar tissue. This process is inherent to skin healing and cannot be completely avoided, although it can be optimally managed with precise surgical technique and structured postoperative follow-up.

The final scar depends on multiple variables: the skin type and phototype of the patient, the anatomical location of the incision, the stress on the wound during healing, the individual genetic predisposition and compliance with the care recommended by the specialist. In the context of aesthetic surgery in Mallorca, the personalized surgical plan includes from the choice of the access approach to the scar care protocol for each case.

Types of Scars Depending on the Surgical Technique

The location and extent of the incisions are directly determined by the breast procedure performed:

• Breast augmentation (augmentation mammoplasty): The most common approaches are periareolar (at the lower border of the areola), inframammary (in the inframammary fold), and axillary. The inframammary and periareolar incisions allow for a moderately long scar that is well integrated into natural skin transition areas.
• Mastopexy (breast lift): Depending on the degree of ptosis, it may require an isolated periareolar scar, a lollipop scar (periareolar + vertical), or an inverted T scar (periareolar + vertical + horizontal in the fold). The greater the degree of correction, the more extensive the incisions.
• Breast reduction: It often uses the inverted T pattern, which allows broad redistribution of glandular and skin tissue. Although the scars are more extensive, they are usually concealed by the breast anatomy itself.
• Implant exchange or explantation: The existing scar is generally used, so no new incisions are added in most cases.

The selection of the most appropriate surgical approach is part of the personalized medical assessment prior to surgery, considering the anatomy of each patient and the expected aesthetic result.

Phases of Scar Healing

From a clinical perspective, the scar maturation process develops in several well-defined phases:

1. Inflammatory phase (first 2–4 weeks): The area may appear red, slightly raised, and sensitive. This is a normal physiological response to the tissue repair process.
2. Proliferative phase (1–3 months): The scar may become more prominent and take on an intense pink or reddish color. At this stage, scar tissue is active and growing.
3. Maturation phase (3–18 months): Gradually, the scar tends to flatten, lighten, and soften. The final result is typically estimated between 12 and 18 months after surgery, although this may vary from case to case.

“A scar is an inherent part of the surgical process. With precise technique, meticulous wound closure, and appropriate postoperative follow-up, scar healing can be optimized significantly. Each patient receives a care protocol tailored to their skin type and individual characteristics.”

— Dr. García Ceballos, FCCP · Plastic Surgeon · Mallorca Medical Group

Factors That Influence the Scar Outcome

Not all patients heal in the same way. Various individual and external factors condition the final appearance of the scar:

• Skin phototype: More highly pigmented skin may develop more marked post-inflammatory hyperpigmentation.
• Genetic predisposition: Some patients have a greater tendency to develop hypertrophic or keloid scars. Preoperative assessment helps identify this risk.
• Incision location: Areas subjected to greater mechanical tension heal differently from areas under less tension.
• Adherence to the postoperative protocol: The use of silicone sheets, strict photoprotection, and scar massage are clinically supported measures to improve the outcome.
• Smoking: Tobacco negatively affects tissue vascularization and may compromise healing. Cessation is recommended before and after surgery.
• Nutritional status and general health: Adequate nutrition and control of systemic diseases such as diabetes mellitus support higher-quality healing.

Postoperative Care to Optimize the Scar

Postoperative follow-up in breast surgery includes specific measures aimed at supporting scar maturation:

• Sun protection: Scars should be protected from ultraviolet radiation for at least 12 months. Unprotected sun exposure may cause permanent hyperpigmentation.
• Silicone sheets and gels: Continued use, generally starting 4–6 weeks after surgery, has been shown to improve scar hydration and elasticity, reducing thickness and discoloration.
• Scar massage: Started when indicated by the specialist, it helps with desensitization and scar flattening.
• Follow-up with the surgeon: Periodic check-ups allow early detection of any alteration in the scarring process and individualized adjustment of the treatment.

In cases where the scar shows an unfavorable evolution (hypertrophic scar, keloid or significant hyperpigmentation), there are additional therapeutic options such as corticosteroid infiltration, fractional laser treatment or, in selected cases, surgical revision of the scar.

When Should You Consult a Specialist About a Scar?

It is advisable to consult your plastic surgeon if the scar shows any of the following signs:

• Progressive thickening beyond the first few weeks.
• Scar growth beyond the boundaries of the original incision (possible keloid).
• Intense or persistent itching in the area.
• Marked hyperpigmentation that does not improve after the first few months.
• Any change that causes aesthetic or functional concern.

Breast surgery, whether breast augmentation, mastopexy or reduction, is one of the most demanded plastic surgery procedures in Mallorca with well-established safety protocols. Individualized preoperative assessment and structured postoperative follow-up are key elements to optimize both the aesthetic result and the scarring process.

Request your personalized assessment with Dr. García Ceballos FCCP at Mallorca Medical Group. Book your appointment at mallorcamedicalgroup.com or call 971 254 686.