Scar Care After Plastic Surgery: Silicone, Sun Protection, Massage, and Timing

How a surgical scar changes over two years

A fresh incision line usually looks its worst in the first months: pink or red, sometimes raised, firm and itchy. That is part of normal remodeling, not a verdict on your result. NHS Lothian's scar-management guidance (2024) notes that scars can take up to two years to fully mature, and that pink scars from wounds that healed quickly tend to fade over several months.

Two practical consequences follow. First, the scar you see when you fly home from Medellín is not the scar you will have. Second, any decision about revising a scar is usually best made once it has matured; our article on how long to wait before a revision explains why patience matters.

Rule one: nothing goes on an open wound

Scar products are for closed, healed skin. NHS Lothian's guidance starts scar treatment once the wound is healed. A scab, a small open spot along the incision, an unhealed drain site or remaining stitches are still a wound-care problem, governed by your surgeon's dressing instructions. Putting silicone, oils or massage onto an open area can trap moisture, irritate tissue or introduce bacteria. If part of your incision has opened, read our guide to wound separation after plastic surgery and contact your surgeon before doing anything else.

Silicone: sheets or gel

Silicone is the most widely used home scar treatment. NHS Lothian advises wearing silicone sheets, cut to size, for at least 12 hours a day or as directed by your clinician, and applying silicone gel twice a day to a clean scar. If you also use moisturizer, let it absorb first, then let the gel dry for a few minutes.

Your surgeon may have a preferred product or a specific start date. The expensive option is not automatically the effective one; consistent daily use matters more than the brand.

Sun protection for a scar that is still remodeling

NHS Lothian advises protecting scars from the sun for two years, using sunscreen of SPF 30 to 50 with high UVA protection, and reapplying every two hours and after swimming, sweating or towel drying. The UVA "star" system it refers to is a UK label; in the US, look for "broad spectrum" on the bottle.

This matters in Medellín. The city sits close to the equator, the sun is strong all year, and recovering patients often spend time walking outdoors or on balconies. Clothing that covers the scar is the most reliable protection while you are there; sunscreen goes on healed skin only.

Massage and moisturizing

Once the wound has healed, NHS Lothian describes scar massage as gentle circular movements with the pad of a thumb or finger, with pressure increasing as the scar matures. It suggests a non-perfumed, oil-based moisturizer applied in thin layers two to three times a day.

Some surgeons delay or modify massage for particular operations, for example where an incision is under tension. Follow your surgeon's timing rather than a recovery-house schedule that applies the same routine to every patient. Scar massage is also different from manual lymphatic drainage, which targets swelling rather than the scar itself.

Pressure and compression

In specialist scar clinics, custom pressure garments are sometimes used to manage scars, worn for most of the day until the scar matures. That is a different use from the compression garment you wear after body contouring, which mainly supports tissue and limits swelling. Our guide to compression garments after plastic surgery covers that garment. Do not assume your post-surgery garment is treating your scar unless your surgeon has told you it is.

What raises the odds of a poor scar

Unfavorable scarring appears on the American Society of Plastic Surgeons' list of tummy tuck risks. Some contributing factors can be discussed before surgery and some cannot:

• Tension on the incision, from the operation itself or from activity too soon.
• Delayed healing, including small openings, infection or fluid under the skin.
• Nicotine use in the weeks around surgery; see our article on nicotine testing before surgery.
• Your own history of thick or raised scars, which you should mention at consultation.

NHS Lothian distinguishes two problem scar types. A hypertrophic scar is red or purple, raised, firm and itchy, but stays within the original wound edges. A keloid keeps growing after healing and extends beyond them. It also describes contractures, where scar tightening limits movement, which is a particular concern for incisions that cross joints, such as some arm and thigh lifts.

A scar-care calendar by milestone

Illustrative sequence. Your surgeon's timing overrides it.

Scar care during the Medellín part of recovery

For many procedures, most active scar treatment begins after you are home, because the incision is still healing during the first part of the trip. That does not make the Medellín weeks irrelevant. While you are there:

• Keep incisions covered and out of direct sun, even on short walks.
• Protect them from friction: check that garment seams, waistbands and foam edges are not rubbing the line.
• Follow activity limits; straining and bending too soon pull on the closure.
• Take a baseline photo of each incision in good light once dressings come off, so later changes can be compared.
• Ask the surgeon at your final visit to write down when scar care should start and with what.
• Buy silicone and sunscreen once you know what your surgeon wants, rather than a bag of products sold to every patient.

When to have a scar looked at

Book a review, and send photos to your Medellín surgeon, if a scar keeps getting thicker after the first months, spreads beyond the incision line, becomes increasingly painful or itchy, tightens enough to limit movement, or opens up. A dermatologist or plastic surgeon at home can assess it in person; treatment options depend on the diagnosis and should not be guessed from photos.