Scar Care After Plastic Surgery — From Suture Removal to Year One

Phase 1 — Suture line protection (weeks 1–3)

Until the surgical tape is removed and the wound is fully epithelialised, the only scar care you need is gentle cleaning with saline and meticulous sun avoidance. Silicone is not yet applied because the wound surface is still open at a microscopic level.

Keep the area dry for the first 48 hours after the dressing is changed. Tension across the scar is the strongest predictor of widening — avoid bending, stretching or any movement that pulls on the suture line.

Phase 2 — Active scar treatment (week 3 to month 6)

• Silicone gel sheets worn 12–23 hours daily, or silicone gel applied twice daily once tape is off. Silicone is the only topical with strong evidence for hypertrophic scar reduction.
• Scar massage starting at week 4 — firm circular pressure for 5 minutes, twice daily, softens adhesions and improves tissue glide.
• SPF 50 mineral sunscreen on any exposed scar for the full first year. UV exposure during this phase causes permanent hyperpigmentation.
• Avoid hot tubs, saunas and chlorinated pools until week 6 — they macerate the developing scar.

Phase 3 — Maturation (month 6 to month 18)

Scars continue to remodel for up to 18 months, gradually fading from pink to skin tone. A well-cared-for scar at month 12 is dramatically different from one left alone — the difference is almost entirely down to silicone consistency and sun protection during months 3 to 9.

If a scar becomes raised, red or itchy beyond month 3, contact your surgeon. Early intralesional steroid injection or fractional laser treatment is far more effective than waiting for a mature hypertrophic scar.