Understanding Scarring After Plastic Surgery: What to Expect and How It’s Managed

Scarring is a normal and unavoidable part of any surgical procedure. While plastic surgery aims to restore function and improve appearance, all surgery involves incisions, and the body’s natural healing process results in some degree of scarring. Understanding why scars form, how they change over time, and how they are managed can help patients feel more informed and prepared before surgery.

Why Scarring Occurs After Surgery

Scars form as part of the body’s natural wound-healing response. When the skin is cut or injured, the body produces collagen fibres to repair the area and restore strength to the tissue. This repair process creates a scar. The size, appearance, and final outcome of a scar can vary from person to person and depends on a range of factors.

Plastic surgery does not eliminate scarring, but careful surgical planning and technique can help place scars in less noticeable areas and support healing.

Factors That Influence How a Scar Heals

Scar formation and appearance are influenced by several individual and surgical factors, including:

Location of the incision, as some areas of the body heal more favourably than others
Type and extent of surgery performed
Skin type and genetic factors, including a tendency toward thicker or raised scars
Tension on the wound during healing
Overall health, including nutrition and circulation
Smoking, which is known to impair wound healing
Adherence to post-operative care instructions

Your surgeon will consider all of these factors when planning your procedure and discussing expected outcomes.

How Plastic Surgeons Plan to Minimise Scarring

Specialist plastic surgeons are trained to plan incisions carefully and close wounds in a way that supports healing and scar quality. This includes:

Placing incisions along natural skin creases where possible
Using layered closure techniques to reduce tension on the skin
Preserving surrounding tissues to support blood supply
Balancing functional requirements with aesthetic considerations

These principles apply across cosmetic, reconstructive, skin cancer, and hand surgery procedures.

Scarring in Reconstructive and Skin Cancer Surgery

In reconstructive and skin cancer surgery, the primary goal is complete removal of disease or restoration of function. Once this is achieved, careful reconstruction is performed to support wound healing, preserve movement, and maintain natural contours. In many cases, reconstruction is carried out at the same time as tumour removal to reduce healing time and improve outcomes.

What Scars Typically Look Like Over Time

Scars change gradually as they heal and mature. In the early weeks, scars may appear red, raised, or firm. Over several months, they usually soften, flatten, and fade in colour. Full scar maturation can take up to 12–18 months.
It is important to understand that while scars often become less noticeable over time, they do not disappear completely.

Scar Management After Surgery

Post-operative care plays an important role in scar quality. Your surgical team will provide guidance based on your procedure, which may include;

Keeping the wound clean and protected
Avoiding sun exposure and using sun protection
Silicone gels or sheets, where appropriate
Gentle scar massage once healing allows
Attending follow-up appointments to monitor healing

Following these instructions carefully can help support the best possible outcome.

When Scars May Need Further Treatment

In some cases, scars may become thickened, raised, or tight, or may affect movement, particularly across joints. When this occurs, additional treatments may be considered, such as scar therapy, injections, or surgical revision. Any further treatment is assessed on an individual basis and discussed carefully with your surgeon.

Setting Realistic Expectations

While plastic surgeons aim to minimise scarring and support good healing, it is important to have realistic expectations. Scar appearance varies between individuals, and outcomes cannot be guaranteed. Your surgeon will only recommend procedures when the expected benefits outweigh the risks and will discuss likely scar outcomes as part of the consent process.