Top Surgery Scar Care: Tips for Optimal Healing After FTM Top Surgery

One of the most common questions patients ask before FTM top surgery is, “What will my scars look like?” While every surgical procedure results in some degree of scarring, there are many steps you can take to support healthy healing and help your scars mature as favorably as possible.

At The Cosmetic Concierge, we believe scar care is an important part of the overall top surgery journey. Our team provides detailed postoperative instructions and ongoing support to help patients heal safely while achieving the best possible aesthetic outcome.

This guide explains how scars heal after chest masculinization surgery, when to begin scar care, and evidence-based practices that can help optimize your results.

Why Do Top Surgery Scars Form?

Scars are a normal part of the body’s healing process. Whenever an incision is made, your body repairs the tissue by producing collagen to close the wound. Over time, this collagen remodels, allowing scars to gradually become flatter, softer, and lighter in color.

The appearance of your scars depends on many factors, including:

• Your genetics
• Skin tone and skin type
• Age
• Overall health
• Nutrition
• Smoking or nicotine use
• Sun exposure
• The surgical technique used
• How closely postoperative instructions are followed

While no treatment can completely eliminate scars, proper care can often improve their appearance as they mature.

What Do Top Surgery Scars Look Like?

The location and size of scars depend on the surgical technique performed.

Double Incision Top Surgery

Patients who undergo double incision top surgery typically have two horizontal or gently curved scars along the lower chest. We welcome input from our patients as some have more specific requests. These incisions allow the surgeon to remove chest tissue, contour the chest, and reposition the nipples when appropriate.

Initially, the scars may appear pink, red, or raised. Over the following months, they usually soften and fade as healing progresses.

Keyhole Top Surgery

Patients who undergo keyhole top surgery generally have much smaller scars located along the border of the areola. Because the incisions are smaller, the resulting scars are often less noticeable, although every patient heals differently.

Regardless of the technique, scars continue to mature for many months after surgery.

The Stages of Scar Healing

Understanding how scars change over time can help set realistic expectations.

Weeks 1–3: Early Healing

During the first few weeks:

• Incisions are still closing.
• Swelling is common.
• Bruising gradually improves.
• The body begins producing collagen.

Your primary focus during this stage is protecting the incisions and following your surgeon’s wound care instructions.

Weeks 4–8: Active Healing

Once your surgeon confirms the incisions have healed appropriately, you may be instructed to begin scar management.

During this period, scars may appear:

• Red
• Pink
• Firm
• Slightly raised

This is a normal phase of healing.

Months 3–12: Scar Maturation

Over the following months:

• Collagen reorganizes.
• Scars gradually flatten.
• Redness slowly fades.
• The texture becomes softer.
• The overall appearance continues to improve.

Many patients notice meaningful improvement throughout the first year after surgery, although scar maturation can continue even longer.

When Should You Start Scar Care?

Scar care should only begin after your surgeon confirms that your incisions have healed sufficiently.

Starting too early can interfere with wound healing or increase the risk of irritation.

Your surgeon will let you know when it is appropriate to begin scar management based on your individual healing progress.

Tips for Optimal Top Surgery Scar Healing

1. Follow Your Surgeon’s Instructions

Every patient heals differently.

The most important factor in achieving a favorable scar is following the postoperative instructions provided by your surgical team.

Avoid comparing your healing timeline with someone else’s on social media or online forums.

2. Protect Your Incisions During Early Healing

Before your incisions are fully healed:

• Keep the area clean and dry according to your surgeon’s instructions.
• Avoid unnecessary tension on the incisions.
• Wear your compression garment as directed.
• Attend all scheduled follow-up appointments.

Proper wound care lays the foundation for healthy scar formation.

3. Consider Silicone-Based Scar Therapy

Silicone products are among the most widely recommended nonsurgical options for scar management.

Depending on your surgeon’s recommendation, this may include:

• Silicone sheets
• Silicone gel

These products are commonly used after incisions have healed and may help improve scar texture and appearance over time.

Use any scar treatment only after discussing it with your surgical team.

4. Massage Scars if Recommended

Some surgeons recommend gentle scar massage after healing has progressed sufficiently.

Scar massage may help:

• Improve flexibility
• Reduce tightness
• Soften scar tissue

However, massage should only begin after receiving clearance from your surgeon. We often do not recommend starting this process until a minimum of 6 weeks have passed.

5. Protect Your Scars from the Sun

Ultraviolet (UV) exposure can cause healing scars to darken and become more noticeable.

For at least the first year after surgery:

• Keep scars covered when possible.
• Use a broad-spectrum sunscreen on healed scars if they will be exposed to sunlight.
• Avoid prolonged direct sun exposure.

Sun protection is one of the simplest ways to support better long-term scar appearance.

6. Eat a Healthy, Protein-Rich Diet

Healing skin requires adequate nutrition.

A balanced diet that includes:

• Lean protein
• Fruits
• Vegetables
• Whole grains
• Healthy fats

Can help support your body’s natural healing process.

Staying well hydrated is also important during recovery.

7. Avoid Nicotine

Nicotine reduces blood flow to healing tissues and can interfere with wound healing.

Smoking, vaping, and other nicotine products increase the risk of:

• Delayed healing
• Poor scar quality
• Wound complications

If you’ve stopped nicotine before surgery, continue avoiding it throughout your recovery for the best chance of optimal healing.

8. Be Patient

Perhaps the most overlooked aspect of scar care is patience.

Scars change gradually.

It’s normal for scars to appear darker or more noticeable before they begin to fade. Many patients are surprised by how much their scars continue to improve between six months and one year after surgery.

Factors That Affect Scar Appearance

Several factors influence how your scars heal, including:

• Genetics
• Skin pigmentation
• Age
• Nutrition
• Overall health
• Surgical technique
• Tension on the incision
• Infection or wound complications
• Sun exposure
• Nicotine use

Some of these factors are outside your control, while others—such as following postoperative instructions and protecting your scars from the sun—can make a meaningful difference.

Common Questions About Top Surgery Scars

• Will my scars disappear completely?

No. All surgical incisions heal with some degree of permanent scarring. However, scars generally become less noticeable over time as they mature.

• Do all patients scar the same way?

No. Scar appearance varies significantly between individuals due to genetics, skin type, and healing characteristics.

• Can I exercise while my scars are healing?

Return to exercise should follow your surgeon’s recommendations. Returning to strenuous activity too soon may place unnecessary tension on healing incisions.

• Can scar creams completely remove scars?

No topical product can completely erase a scar. Some products may improve scar texture or appearance, but realistic expectations are important. Discuss any treatment you’re considering with your surgeon before using it.

• When Should You Contact Your Surgeon?

Although mild redness, firmness, and itching are common during healing, you should contact your surgical team if you notice:

• Increasing redness around the incision
• Drainage that concerns you
• Fever or chills
• Worsening pain
• Separation of the incision
• Significant swelling that develops suddenly

Prompt evaluation can help identify and manage potential complications.

• Why Experience Matters

Excellent scar outcomes begin with meticulous surgical technique, but they also depend on careful postoperative care and communication between you and your surgical team.

At The Cosmetic Concierge, we provide detailed recovery instructions, scheduled follow-up visits, and personalized guidance throughout your healing journey. Our goal is to help every patient recover safely while achieving a chest contour that reflects their goals and supports their confidence.

Schedule Your FTM Top Surgery Consultation

If you’re considering FTM top surgery or chest masculinization surgery, choosing an experienced, compassionate surgical team is one of the most important decisions you’ll make.

During your consultation, we’ll discuss your goals, explain the surgical techniques available, review what recovery and scar healing may look like, and provide personalized recommendations to help you achieve the best possible outcome.

Contact The Cosmetic Concierge today to schedule your consultation and learn more about gender-affirming top surgery in North Carolina.