Top Surgery Scarring

Top surgery, a life-changing procedure for many transgender individuals, involves the removal or reduction of breast tissue to achieve a more masculine chest (for transgender men) or a flatter, gender-neutral chest (for non-binary individuals). While top surgery offers incredible physical and psychological benefits, one aspect that concerns many individuals considering the procedure is scarring.

In this comprehensive guide, we will delve deep into the topic of top surgery scarring. We will discuss what causes scars, different surgical techniques and their impact on scarring, scar management strategies, and ways to minimize scarring. By the end of this article, you’ll have a thorough understanding of top surgery scars and the tools to help you make informed decisions about your top surgery journey.

Understanding Scarring

Scarring is a natural part of the body’s healing process. Whenever there is an injury or surgery, the body initiates a complex series of processes to repair the damaged tissue. This repair often results in the formation of scars. The degree and appearance of scarring can vary widely based on several factors, including genetics, skin type, and the quality of wound care.

Factors Influencing Scarring

Before we dive into the specifics of top surgery scarring, let’s explore the factors that influence how scars form:

  1. Genetics: Genetics plays a significant role in how an individual’s body heals and scars. Some people are genetically predisposed to form thicker or more noticeable scars.
  2. Skin Type: Different skin types have varying tendencies to scar. Darker skin tones may be more prone to hyperpigmentation (darkening of the scar) or keloid formation (raised, thick scars).
  3. Wound Care: Proper wound care during the post-operative period can greatly affect how scars develop. Careful cleaning, moisturizing, and protecting the incision sites can promote optimal healing.
  4. Surgical Technique: The surgeon’s skill and the surgical technique used can impact scarring. Some techniques are designed to minimize scarring, while others may result in more visible scars.
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Top Surgery and Scarring

Top surgery, also known as chest masculinization surgery or breast augmentation surgery, typically involves the removal of breast tissue and reshaping the chest to create a more masculine or gender-neutral appearance. The specific surgical approach used can vary based on factors such as the patient’s anatomy, desired outcome, and surgeon’s expertise. Here are the most common surgical techniques for top surgery and their impact on scarring:

1. Double Incision (DI) Mastectomy

Description: In a double incision mastectomy, horizontal incisions are made beneath the pectoral muscles, and the breast tissue is removed. This technique allows for substantial tissue removal and chest contouring.

Scarring: Double incision mastectomy typically results in two horizontal scars, one under each pectoral muscle. These scars are usually well-concealed beneath the pectoral muscles and can often be hidden under clothing.

2. Peri-Areolar Incision

Description: The peri-areolar incision, also known as the keyhole or circumareolar incision, involves making an incision around the edge of the areola. It is often used for individuals with smaller breasts or those who want to retain nipple sensation.

Scarring: Scarring with this technique is usually minimal and well-camouflaged along the border of the areola. However, the extent of scarring can vary depending on the surgeon’s skill and the patient’s healing process.

3. Inverted-T or Anchor Incision

Description: The inverted-T or anchor incision combines a peri-areolar incision with a vertical incision that extends downward from the areola to the inframammary fold, creating an anchor-like shape. This technique is often used for individuals with larger breasts or more significant tissue removal needs.

Scarring: The inverted-T technique typically results in more extensive scarring, including a vertical scar in addition to the peri-areolar scar. The vertical scar may fade over time but can be more noticeable initially.

Early Post-Operative Care and Scar Management

After top surgery, the early post-operative care you receive and your dedication to scar management can significantly impact how your scars heal and their final appearance. Here are some crucial steps to consider:

1. Follow Post-Op Instructions

Your surgeon will provide specific post-operative instructions, including wound care guidelines. It’s essential to follow these instructions meticulously. This may include keeping the incision sites clean, changing dressings as instructed, and avoiding activities that could strain the healing incisions.

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2. Scar Massage

Scar massage is a gentle technique used to break down scar tissue and promote proper healing. You can start scar massage once your surgeon gives you the green light. Using a moisturizing cream or silicone-based gel, gently massage the scar in a circular motion for several minutes each day.

3. Silicone Gel Sheets

Silicone gel sheets have been shown to be effective in reducing scar thickness and discoloration. These sheets are placed directly on the scars and should be worn for several hours each day. They can be particularly helpful for individuals with thicker or raised scars.

4. Silicone Gel Creams

Silicone gel creams or ointments are another option for scar management. Apply a thin layer to the scars and massage it in for several minutes. Silicone helps hydrate the scar and improve its texture and appearance.

5. Sun Protection

Protecting your healing scars from the sun is crucial. UV rays can cause scars to darken and become more noticeable. Use a broad-spectrum sunscreen with an SPF of at least 30 on your scars when exposed to sunlight.

6. Scar Healing Products

There are various over-the-counter scar healing products, such as gels, creams, and silicone sheets, available in the market. These products may contain ingredients like onion extract, vitamin E, or aloe vera, which can help improve the appearance of scars. However, results may vary, and it’s essential to use them as directed.

7. Compression Garments

Compression garments can help reduce swelling and provide support to the chest area during the initial healing phase. Your surgeon may recommend wearing a compression binder or vest for several weeks post-surgery.

Long-Term Scar Care and Maintenance

Scars continue to evolve and change over time, even years after top surgery. To ensure your scars continue to improve and fade, consider the following long-term scar care strategies:

1. Patience

Scars take time to mature and fade. It can take up to a year or more for scars to reach their final appearance. Be patient and give your body the time it needs to heal.

2. Regular Follow-Ups

Keep your scheduled follow-up appointments with your surgeon. They can assess the progress of your scars and provide guidance on any additional scar management strategies.

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3. Scar Revision

In some cases, scar revision surgery may be an option if you are dissatisfied with the appearance of your scars. This procedure involves making adjustments to the scar tissue to improve its appearance. However, it’s typically recommended to wait at least a year before considering scar revision.

4. Laser Therapy

Laser therapy, such as fractional laser resurfacing, can be used to improve the texture and color of scars. It works by stimulating collagen production and promoting smoother skin.

Emotional Support

While physical

scar care is essential, it’s also crucial to address the emotional aspects of scarring. Scars can carry emotional weight, and it’s normal to have mixed feelings about them. Consider seeking support from therapists, support groups, or friends and family who can provide understanding and encouragement during your healing journey.

Tips for Minimizing Top Surgery Scarring

While it’s impossible to completely eliminate scars, there are steps you can take to minimize their visibility and promote optimal healing. Here are some additional tips:

1. Choose an Experienced Surgeon

Selecting a skilled and experienced surgeon who specializes in top surgery is one of the most critical decisions you’ll make. A skilled surgeon can minimize scarring by using precise surgical techniques and paying close attention to incision placement.

2. Maintain Good Overall Health

Your general health can impact how well your body heals. Follow a balanced diet, stay hydrated, and avoid smoking, as smoking can impair circulation and delay the healing process.

3. Stay Hydrated

Keeping your body well-hydrated can promote healthy skin and improve the healing process. Drinking enough water is essential for overall skin health.

4. Avoid Excessive Sun Exposure

As mentioned earlier, UV rays can darken scars. If you’re spending time in the sun, wear protective clothing and sunscreen to shield your scars from direct sunlight.

5. Consider Scar-Reducing Treatments

If you’re concerned about scarring before your surgery, discuss scar-reducing options with your surgeon. Some surgeons offer treatments like platelet-rich plasma (PRP) injections or steroid injections to minimize scarring.

Embracing Your Scars

Ultimately, it’s essential to remember that scars are a natural part of the healing process. They tell a story of your journey and the strength it took to be your true self. Many individuals find that over time, their scars become less prominent and something they embrace as a symbol of their identity and courage.


Top surgery is a transformative procedure that can greatly improve the lives of transgender and non-binary individuals. While scarring is a natural part of the healing process, there are steps you can take to minimize its visibility and promote optimal healing. By following proper wound care, scar management, and seeking support when needed, you can navigate your top surgery journey with confidence, knowing that your scars are a testament to your strength and authenticity. Remember, you are not defined by your scars, but by the unique and beautiful person you are.