Top Surgery Scars in FTM Individuals: Healing, Care, and Reduction

Top surgery is a life-changing procedure for transgender and non-binary individuals seeking a more masculine chest. While the surgery itself is a huge step towards gender affirmation, one aspect many people think about is scarring. How will it look? How can it be reduced? Will it fade over time?

This article provides a comprehensive, easy-to-follow guide on top surgery scars, including healing, care, and available treatments. Whether you're planning your surgery or in recovery, this guide will help you understand what to expect and how to manage your scars effectively.

Types of Top Surgery and Resulting Scars

The type of surgical technique used plays a significant role in the location, size, and appearance of scars.

 

Key Takeaways:

• Keyhole method results in the least scarring but is only suitable for small chests.

• Double incision method offers more chest contouring but results in visible scars across the chest.

• Surgical skill plays a major role in how well the scars heal.

Stages of Scar Healing

Understanding the three primary healing stages can help you manage expectations and take the right steps to improve scar healing. Each stage plays a crucial role in how your scar forms, matures and fades over time.

1️. Inflammatory Phase (0-5 Days) - The Initial Healing Response

This is the body's first response to surgery, focusing on wound protection and repair.

What Happens?

• The incision site will appear red, swollen, and possibly bruised.

• Mild pain or tenderness is common, but should be manageable with medication.

• Blood clotting begins immediately, forming a protective layer to prevent infection.

• White blood cells rush to the area, fighting off bacteria and starting the repair process.

What to Do:

• Keep the area clean and dry.

• Take prescribed pain relievers if needed.

• Avoid touching, rubbing, or scratching the incision.

• Follow your surgeon’s post-op instructions carefully.

Warning Signs to Watch For:

• Excessive swelling, warmth, or pus-like discharge could indicate an infection.

• Severe pain that doesn’t improve with medication.

• Fever or chills—seek medical attention immediately.

2. Proliferative Phase (Weeks 2-6) - Scar Formation Begins

This is when the real scar-building process happens. The body focuses on closing the wound and forming new tissue.

What Happens?

• Your body starts producing collagen, which gives the scar structure.

• The scar may look raised, thick, or red—this is completely normal.

• Some people experience itchiness or slight discomfort due to skin tightening.

• Swelling begins to subside, but the incision might still feel firm or bumpy.

What to Do:

• Start gentle scar massage (only if approved by your surgeon) to promote circulation.

• Apply silicone gels or sheets to keep the scar hydrated.

• Avoid heavy lifting or stretching that could put tension on the scar.

• Keep wearing your compression vest as directed.

Warning Signs to Watch For:

• If the scar becomes increasingly painful, itchy, or thick, consult your doctor.

• Some people develop hypertrophic scars or keloids, which require early treatment.

3. Maturation Phase (Months to Years) - Scar Softening and Fading

This is the longest phase, where the scar slowly flattens, softens, and fades.

What Happens?

• The scar transitions from red to pink, then to a lighter color that blends with your skin.

• Collagen production slows down, making the scar less raised and rigid.

• Final scar appearance may take 12-18 months (or longer for some individuals).

What to Do:

• Continue moisturizing and massaging the scar.

• Use SPF 30+ sunscreen to prevent darkening (even after a year).

• Maintain a healthy diet (protein, vitamins A & C, zinc help with skin repair).

• If the scar remains thick or discolored, consider laser therapy or steroid injections.

Warning Signs to Watch For:

• If your scar doesn’t fade after a year, consult a specialist for advanced treatments.

• Raised, itchy, or dark scars may require medical intervention.

How Long Does It Take for Scars to Fully Heal?

Scar healing takes time, but with proper care, most scars fade significantly within 12-18 months.

By understanding these healing stages, you can take proactive steps to minimize scarring and speed up recovery. Always follow your surgeon’s advice and be patient with your body’s healing process.

Factors That Influence Scar Appearance

Many factors determine how scars develop and fade. 

Internal Factors (Uncontrollable)

• Genetics – Some people naturally form thicker scars.

• Skin Tone – Darker skin tones are prone to hyperpigmentation.

• Age – Younger individuals may form thicker scars due to higher collagen production.

 External Factors (Controllable)

• Post-op care – Following aftercare instructions reduces scarring.

• Activity level – Avoid stretching, lifting, and strenuous movement for at least 2-3 months.

• Sun exposure – UV rays darken scars, making them more noticeable.

 Pro Tip: If you’re prone to thick scars, talk to your surgeon about preventative treatments like silicone gels or steroid creams.

Post-Operative Scar Care: Do’s and Don’ts

Proper scar care starts immediately after surgery and continues for at least a year.

 Risk Alert: Overactivity too soon widens scars. Wait at least 2-3 months before resuming upper body workouts.

Scar Reduction Techniques

If you’re concerned about your scars, there are several treatments that can improve their appearance.

 Topical Treatments

• Silicone Sheets & Gels – Most effective non-surgical option for flattening scars.

• Vitamin E & Onion Extract – May help with hydration, but results vary.

• Retinoid Creams – Promotes collagen remodeling but can irritate sensitive skin.

 Non-Surgical Procedures

Surgical Scar Revision

• For severe scars, revision surgery can reshape and refine the appearance of scars.

• Usually considered at least 1 year post-op.

 Fact: 85% of top surgery patients report that scars fade significantly with proper care!

Long-Term Scar Maintenance

Even after the initial healing phase, long-term care helps improve scar appearance.

Recommended Long-Term Care Routine:
Massage scars daily – Use gentle circular motions for 5-10 minutes.
Moisturize regularly – Keeps skin soft and flexible.
Continue sun protection – UV rays can darken scars even after 1 year.
Stay consistent – Scar treatments take several months to show results.

Fact: Many people embrace their scars as a sign of their journey—some even tattoo over them!

Final Thoughts

Top surgery scars are a normal part of healing, but they don’t have to define your results. By following proper aftercare and using the right treatments, you can ensure that your scars heal as smoothly and discreetly as possible.

 Key Takeaways:
Healing is a long process—be patient with your body.
  Post-op care plays a huge role in final scar appearance.
There are many ways to minimize and treat scars.
Your scars are part of your journey—own them, reduce them, or embrace them!

Would you like to discuss scar treatment options with a professional? Consult with a gender-affirming surgeon to find the best approach for you! 

 

FAQs on FTM Top Surgery Scars

 How long does it take for scars to fully heal?

• Scars take 12-18 months to fully mature and fade.

Can scars be completely removed?

• No, but they can be significantly reduced with proper care and treatments.

Can I prevent hypertrophic or keloid scars?

• Yes! Silicone sheets, steroid creams, and avoiding excessive movement help prevent raised scars.

Is revision surgery worth it for scars?

• If scars are very thick or uneven, revision surgery can improve appearance.