Augmentation mastopexy leaves scars around the areola and, in most cases, a vertical line down to the breast crease, sometimes with a horizontal scar along the crease itself. The pattern depends on how much the breast needs lifting. Scars are usually red and raised for the first few months, then gradually soften and fade over 12 to 18 months, and most sit within the coverage of a bra or bikini top.
Why a lift needs more incisions than an augmentation
A standard breast augmentation can often be done through a single short incision in the breast crease. When a lift is added, excess skin has to be removed and the nipple repositioned higher, which requires incisions on the breast itself. The more skin there is to remove and the lower the nipple sits, the longer the scars need to be. Adding an implant can sometimes reduce the amount of lift required, but it does not remove the need for these incisions.
The three main scar patterns
- Periareolar (donut): a circle around the edge of the areola, used for a mild lift. It is the most discreet pattern but can stretch or flatten the areola if used for too much correction.
- Vertical (lollipop): a circle around the areola plus a line running straight down to the breast crease. Suitable for moderate droop and commonly used.
- Wise pattern (anchor): the lollipop scar plus a horizontal line along the fold under the breast. Used for more significant droop or larger amounts of excess skin.
Mr Nassab will explain which pattern fits your anatomy and show you where each line would sit before you decide.
How scars change over time
Scar maturation follows a fairly predictable course:
- Weeks one to six: the incisions heal and look pink, sometimes with small scabs, particularly where lines meet.
- Months two to six: scars often become redder, firmer and slightly raised as collagen is laid down. This is normal and usually peaks around three months.
- Months six to eighteen: scars gradually flatten, soften and fade to a paler, silvery line.
Scars never disappear completely, and the final appearance varies with skin type, genetics and healing.
Caring for your scars
Good scar care starts once the wounds have fully closed, usually around three weeks after surgery.
- Silicone: gel or sheets applied daily for at least three months can help flatten and soften scars.
- Massage: gentle, firm massage with a plain moisturiser helps soften the tissue once you are advised it is safe.
- Sun protection: keep scars covered or use a high-factor sunscreen for at least a year, as sun exposure can darken them.
- Support: wearing your surgical bra as advised reduces tension on healing incisions.
- No smoking: nicotine impairs blood flow and healing, which can worsen scarring.
Factors that affect how scars look
Some people are prone to thicker scars. Hypertrophic scars are raised but stay within the original line, while keloid scars grow beyond it and are more common in darker skin types and people with a family history. Tension on the wound, larger implants, infection, wound breakdown and weight gain can all affect the final result. Mention any history of poor scarring at your consultation so it can be factored into planning.
If scars heal poorly
If scars remain thick, wide or uncomfortable after they have matured, several options exist. Steroid injections can flatten raised or keloid scars, and silicone therapy can be continued. Surgical scar revision may improve a stretched or uneven scar once it is fully mature, typically after at least 12 months. These treatments aim to improve appearance rather than erase the scar.
Frequently Asked Questions
Will the scars be visible in a bikini?
Most scars sit within the area covered by a bra or bikini top, although the circular scar around the areola may be visible with very low-cut styles.
Can augmentation mastopexy be done without scars on the breast?
Not usually. Any lift that raises the nipple and removes skin requires incisions on the breast. Where only volume is lacking, an augmentation alone may be enough.
How long do the scars stay red?
Redness typically peaks around three months and fades gradually over 12 to 18 months.
Are anchor scars worse than lollipop scars?
Anchor scars are longer, but they allow more correction for significant droop. The right pattern is the one that achieves a good shape for your anatomy.
When can silicone gel be started?
Usually once the wounds have fully healed and there are no scabs, which is often around three weeks after surgery.
Does the implant need a separate scar?
Usually not. The implant is typically placed through the lift incisions, often the vertical or crease line, so no additional scar elsewhere on the body is needed. Mr Nassab will confirm the planned access route at consultation, as it can vary with your anatomy and the type of lift.
