Gender-affirming procedures are essential for many transgender and nonbinary patients to achieve emotional relief and improved self-confidence. While the outcome is potentially life-changing, many patients worry about scarring.
As a board-certified plastic and reconstructive surgeon in Long Island, Dr. Meredith Vandegrift has helped countless patients confirm their top surgery candidacy. This guide covers what scarring you can expect and how to minimize them for more satisfaction with your results.
Why Scarring Happens After Top Surgery
Scars are part of your natural healing response. Your body will produce collagen fibers to close and repair an injury. Over time, this new tissue strengthens and becomes less noticeable, but the scar will never disappear completely.
While scars are reminders of the transformation brought about by top surgery, it’s only natural to wonder if they will cause dissatisfaction or embarrassment about your appearance. Scar size and placement depend on several factors:
- Surgical technique
- Chest size and skin elasticity
- Healing ability and genetics
- Adherence to postoperative care instructions
Because everyone is unique, scarring outcomes vary. Some patients heal with thin, flat scars that match their skin tone, while others may develop thick, raised, or darker marks.
Scarring after top surgery varies depending on the surgical technique and your skin’s healing response.
- Dr. Vandegrift may suggest the double incision method if you have a larger chest or reduced skin elasticity. This approach removes breast tissue and excess skin, leaving horizontal scars beneath the pectoral line. While these scars are more visible initially, they’ll typically fade over time and blend into your natural chest contours.
- Patients with smaller chests may be candidates for periareolar or keyhole top surgery. These techniques involve incisions around the areolas, resulting in smaller scars that are easier to conceal.
In some cases, raised or thickened scars may form. We call these hypertrophic scars, or keloids when they extend beyond the original incision. They’re more common among people with darker skin tones or a family history of thick scarring. Fortunately, effective treatments are available to manage and minimize these concerns.
Healing is a gradual process. Here’s a general idea of what to expect.
- 0-3 months after surgery: Scars often appear red, firm, or raised. This is a normal part of early healing.
- 3-6 months after surgery: Scars begin to soften, flatten, and fade slightly. Mild itching or tightness may occur.
- 6-12 months after surgery: Continued fading occurs, with scars blending more naturally into surrounding skin.
- 12-18 months after surgery: Most scars reach their final appearance. They are typically lighter in color and less noticeable.
Be patient. Scars take time to mature. Follow Dr. Vandegrift’s recovery plan to ensure the best long-term outcome.
How to Minimize Scarring After Top Surgery
Though you can’t erase scars, you can use proven strategies to reduce their appearance. Dr. Vandegrift provides every patient with tailored recovery instructions that may include the following.
1. Silicone Sheets or Gels
Silicone products are the gold standard for scar management. They create a protective barrier that flattens and lightens scars while reducing redness.
2. Massage
Once your incisions have fully healed, gentle scar massage can break down dense tissue and improve circulation. Dr. Vandegrift will advise you if or when it is safe to begin.
3. Sun Protection
UV rays can permanently darken scars, making them more noticeable. Covering your scars with clothing or applying sunscreen to healed incision lines keeps them lighter and less visible.
4. Healthy Lifestyle Choices
Proper hydration, a balanced diet rich in vitamins and protein, and avoiding smoking all support your body’s ability to heal well.
5. Medical Interventions
If scars are especially raised, thick, or bothersome, various spa services can significantly improve their appearance.
Emotional Perspectives on Scarring
For many people, top surgery scars are visible affirmations of their growth, transition, and empowerment. Others may prefer to minimize or conceal their scars for aesthetic or emotional reasons. Both responses are valid, and each reflects a unique relationship with healing and self-expression.
Dr. Vandegrift encourages you to make choices that align with your emotional and aesthetic goals.
- Scar camouflage tattooing: Skin-toned pigment helps scars blend with surrounding skin.
- Decorative tattoos: Many patients choose meaningful designs to celebrate their transition and personalize their results.
Not every scar heals as expected. If you notice scars that are thick, itchy, or expanding, it may indicate hypertrophic or keloid scarring. While these scars aren’t dangerous, they can be uncomfortable or aesthetically concerning.
Dr. Vandegrift will monitor you closely during follow-up visits. If poor scarring develops, she may recommend:
- Steroid injections to flatten raised scars
- Laser resurfacing to smooth texture and fade pigmentation
- Microneedling to encourage collagen remodeling
- Surgical scar revision in rare cases
Schedule Your Top Surgery Consultation in Long Island, NY
Though scars may seem intimidating before surgery, many patients view them as a small price for reclaiming their bodies and living authentically. Over time, these faded marks often become powerful reminders of strength and self-determination.
Dr. Vandegrift recognizes that every transition is personal. As a board-certified plastic surgeon specializing in gender-affirming care, she offers compassionate, tailored support that honors your aesthetic goals and emotional well-being.
If you’re considering top surgery, schedule a consultation to explore your options, learn what to expect during recovery, and make confident, informed decisions.
Frequently Asked Questions About Scarring
Will my scars ever fade completely?
Scars do not disappear, but most fade to fine, pale lines within 12 to 18 months.
When can I start scar treatments?
You should only begin treatments like silicone or massage once Dr. Vandegrift confirms your incisions have fully healed, usually a few weeks after surgery.
Can I exercise or stretch during top surgery recovery?
Gentle activity can improve your circulation and speed healing, but avoid stretching your chest too drastically until Dr. Vandegrift clears you. Excess strain may widen scars.
What if I develop keloids?
Keloids are treatable with injections, laser therapy, or other interventions. Early treatment often gives the best results.