Top Surgery Scars in FTM Individuals: Healing, Care, and Reduction
The Top Surgery (FTM chest surgery) is a life-changing procedure for trans and non-binary people seeking a more masculine chest. While the surgery itself is a major step toward gender affirmation, many people are especially concerned about scars: What will they look like? Can they be reduced? Will they fade over time?
This article provides a comprehensive, easy-to-understand guide to top surgery scars — including healing phases, care, and available treatments. Whether you’re planning your operation or already in recovery, this guide helps you understand what to expect and how to manage your scars effectively.
Types of FTM Top Surgery and Resulting Scars
The chosen surgical technique has a decisive impact on the location, size, and appearance of scars.
Minimal scarring around the areola
Best suited forSmall chest, good skin elasticity
Also calledKeyhole Method
Two horizontal chest scars + possible nipple graft scars
Best suited forLarger chest, excess skin
Also calledDouble Incision
Additional vertical scar between horizontal incisions
Best suited forSignificant excess skin
Also calledAnchor Method
Key takeaways:
- The Keyhole method causes the least scarring but is only suitable for small chests.
- The Double incision allows more contouring but leads to visible scars across the chest.
- The surgeon’s experience strongly influences scar healing.
Phases of Scar Healing After FTM Top Surgery
Understanding the three main phases helps you manage expectations and choose the right care for optimal scar healing.
Inflammatory phase — Initial healing response
What happens?Redness, swelling, clotting; immune response starts.
DoKeep area clean/dry, take meds, follow post-op instructions.
Watch forWarmth, pus, severe pain, fever/chills → seek care.
Proliferative phase — Scar formation begins
What happens?Collagen builds; scar may be raised/red; itchiness is common.
DoGentle massage (if cleared), silicone gels/sheets, compression, avoid strain.
Watch forIncreasing pain/thickening; treat hypertrophic/keloid early.
Maturation phase — Scars soften and fade
What happens?Color fades; scar flattens and softens.
DoMoisturize, massage, SPF 30+, balanced diet; consider laser/steroid if thick.
Watch forNo improvement ~1 year; raised/itchy/dark scars → specialist.
Scar healing takes time — with proper care, most scars noticeably fade within 12–18 months.
Factors That Influence Scar Appearance
How visible scars remain after transgender chest surgery depends on several factors.
Internal factors (not controllable)
- Genetics — some people naturally develop thicker scars.
- Skin type — darker skin tones are more prone to hyperpigmentation.
- Age — younger people produce more collagen → tend to form thicker scars.
External factors (controllable)
- Post-op care — consistent aftercare reduces scarring.
- Activity level — avoid heavy lifting/stretching for 2–3 months.
- Sun exposure — UV darkens scars and makes them more noticeable.
Pro tip: If you’re prone to thicker scars, discuss preventive options like silicone gels or steroid creams with your surgeon.
Post-Operative Scar Care: Do’s & Don’ts
Consistent care starts immediately after surgery and continues for at least one year.
Do
- Keep the wound clean & follow instructions
- Wear compression garments to reduce swelling
- Use silicone sheets/gels once the wound is closed (about 2–3 weeks)
- Use SPF 30+ / cover up outdoors
- Stay hydrated & eat collagen-supportive foods
Don’t
- Lift heavy or stretch too soon
- Expose scars to direct sun in the first 6–9 months
- Use alcohol, harsh creams, or hydrogen peroxide
- Pick scabs or scratch healing scars
Risk alert: Overexertion too early can widen scars — wait at least 2–3 months before resuming upper-body workouts.
Scar Reduction Methods
If you’re concerned about your scars, there are several treatment options to improve their appearance.
Topical treatments
- Silicone sheets & gels — the most effective non-surgical option to flatten scars.
- Vitamin E & onion extract — may help with hydration; results vary.
- Retinoid creams — promote collagen remodeling; may irritate sensitive skin.
Reduce scar tissue & improve color
Best forRaised or discolored scars
Slow excessive collagen production
Best forThick, hypertrophic, or keloid scars
Stimulate collagen for smoother skin
Best forIndented or uneven scars
Surgical scar revision
- For pronounced scars, a revision surgery can improve shape and appearance.
- Usually considered no earlier than 1 year post-op.
Fact: Around 85% of patients report that scars fade significantly with proper care.
Long-Term Scar Care
Even after the initial healing, consistent long-term care improves the appearance of scars.
Recommended routine:
– Massage scars daily for 5–10 minutes (gentle circular motions)
– Moisturize regularly to keep skin supple
– Continue sun protection (even after 1 year)
– Stay consistent: results take months
Fact: Many people embrace their scars as part of their journey — some even cover them with tattoos.
Conclusion: Understand & Treat Scars After FTM Top Surgery
Top surgery scars are a normal part of healing — with proper aftercare, they don’t have to define the final result. With good care and suitable treatments, scars often heal soft and discreet.
Key points:
- Healing is a long process — be patient with your body.
- Aftercare has a major impact on the final appearance.
- There are many ways to minimize and treat scars.
- Scars are part of your journey — accept them, reduce them, or camouflage them.
Would you like to discuss scar treatments with a professional? Consult a gender-affirming surgeon to find the best approach for you.
FAQs About FTM Top Surgery Scars
How long does it take for scars to fully heal?
Scars take 12–18 months to stabilize and fade.
Can scars be completely removed?
No, but with proper care and treatments they can be significantly reduced.
Can I prevent hypertrophic or keloid scars?
Yes — silicone sheets, steroid creams, and limiting movement help prevent raised scars.
Is a scar-revision surgery worth it?
If scars are very thick or uneven, a revision surgery can improve their appearance.