Breast Surgery

Wound Healing After Surgery: What You Can Do to Get the Best Results

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Wound healing is the body’s natural process of repairing tissue after injury or surgery. For most people, this process leads to a scar — but with the right care, scars can be minimal and fade over time.

🔬 How Wound Healing Works

Wound healing occurs in three overlapping phases:

  • Inflammation (Days 0–4): White blood cells clean the wound and start the repair process
  • Proliferation (Days 4–21): New tissue forms as skin cells, collagen, and blood vessels grow back
  • Remodelling (Weeks to Months): Collagen is reorganised and the scar begins to mature

✅ What Promotes Wound Healing

  • Clean, moist wound environment
  • Adequate oxygen and blood supply
  • Good nutrition (especially protein, vitamin C, zinc)
  • Avoiding excessive tension or trauma to the wound
  • Non-smoking status

🚫 What Impairs Wound Healing

  • Smoking or vaping (reduces oxygen supply)
  • Diabetes or poor blood sugar control
  • Poor nutrition or low protein intake
  • Infection or wound contamination
  • Excessive movement, tension, or UV exposure

Understanding these factors is key to taking proactive steps to heal well and reduce scarring.

🔑 Five Key Strategies to Promote Wound Healing and Minimise Scarring

1. Keep the Wound Moist — Not Dry

Moist wound environments promote faster epithelialisation, reduce scab formation, and lower the risk of hypertrophic scarring.

  • Occlusive dressings (e.g. hydrocolloid, silicone sheets) help speed up healing and reduce scar formation
  • Evidence: Winter GD’s landmark 1962 study first demonstrated that moist wounds heal more quickly than dry wounds. This has since been reaffirmed in modern trials (Atiyeh BS et al., Aesthetic Plast Surg, 2003)【1】

2. Use Silicone Gel or Sheeting

Silicone-based products are one of the most well-supported treatments to improve scar appearance.

  • They reduce water loss from the scar, improve hydration, and modulate collagen production
  • Start once the wound is closed and dry — typically around 7–10 days after surgery
  • Evidence: A Cochrane review confirmed that silicone sheets reduce hypertrophic and keloid scar formation (O’Brien L & Jones DJ, Cochrane Database Syst Rev, 2013)【2】

3. Protect the Wound from the Sun

UV light exposure can worsen pigmentation and increase scar thickening.

  • Use broad-spectrum SPF 30+ sunscreen or cover the scar with clothing or tape
  • Continue sun protection for at least 6–12 months
  • Evidence: Peres et al. (J Eur Acad Dermatol Venereol, 2018) found significantly better scar appearance in patients who used sun protection【3】

4. Reduce Tension on the Scar

Tension on healing wounds leads to thicker, raised scars.

  • Use Micropore tape or silicone tape across the wound for 2–3 months to reduce mechanical stress
  • Evidence: Mustoe et al. showed that long-term taping significantly reduces scar width (Plast Reconstr Surg, 2004)【4】

5. Optimise Nutrition and Lifestyle

Nutrition and lifestyle choices play a major role in wound healing.

  • Key nutrients:
    • Protein: Lean meats, fish, eggs, dairy, legumes, nuts
    • Vitamin C: Citrus fruits, berries, leafy greens, bell peppers
    • Zinc: Red meat, shellfish, legumes, nuts, seeds
    • Iron: Red meat, fortified cereals, spinach, beans
  • Smoking impairs oxygen delivery and increases wound complications
  • Evidence: Sorensen LT (Ann Surg, 2012) found a 3-fold increased risk of complications in smokers【5】

🏠 What You Can Do at Home

Healing doesn’t stop when you leave the hospital — in fact, this is when your role becomes most important. The actions you take at home will make a big difference in your final scar.

📅 First 1–2 Weeks: Protect and Leave the Wound Alone

Goal: Prevent infection and allow early healing

Actions:

  • Keep the dressings clean and dry
  • Do not remove the dressings unless advised
  • Dressings are usually left in place for 1 to 2 weeks
  • Avoid getting the area wet in the shower unless waterproof dressings are used
  • Do not apply creams, oils, or home remedies to the dressing or wound

📅 After Dressings Are Removed (Typically Day 10–14)

Goal: Promote skin regrowth and begin scar prevention

Actions:

  • Gently clean the wound daily with saline or mild soapy water
  • Pat dry — avoid rubbing or scrubbing
  • Begin silicone gel or sheeting once the wound is fully closed and dry
  • Avoid activities that stretch or stress the wound

📅 Weeks 2–8: Scar Maturation Begins

Goal: Flatten and soften the scar

Actions:

  • Continue silicone gel or sheeting for 12–24 hours/day
  • Begin scar massage once approved by your surgeon — firm circular motions for 5–10 minutes, twice daily
  • Apply Micropore or silicone tape to reduce tension
  • Use SPF 30+ sunscreen on any exposed scars

📅 Months 2–6: Long-Term Remodelling

Goal: Maintain scar improvement and prevent abnormal scarring

Actions:

  • Continue silicone products for up to 6 months
  • Maintain daily scar massage
  • Avoid direct sun exposure; continue using sunscreen
  • Controlled movement and exercise: Gentle, surgeon-approved exercise helps improve circulation and tissue remodelling. Avoid heavy lifting or stretching across the wound site early on
  • Monitor for raised, thickened, or painful scars — seek early advice

📅 6–12 Months: Maintenance Phase

Goal: Protect and monitor the scar

Actions:

  • Continue sun protection on exposed scars
  • Contact your doctor if the scar becomes itchy, red, thickened, or raised
  • Additional treatment options may be considered if needed

❗ What Can Be Done If There Is Excessive Scarring

If a scar becomes thick, raised, painful, itchy, or cosmetically concerning, there are effective treatment options. The earlier problematic scars are treated, the better the result.

Options include:

  • Corticosteroid injections: Reduce inflammation and flatten hypertrophic or keloid scars
  • Silicone therapy continuation: Resume or intensify silicone gel or sheeting
  • Laser therapy: Reduces redness and improves scar texture
  • Pressure therapy: Commonly used in burn scars
  • Surgical revision: May be offered if the scar causes discomfort or functional issues

Always discuss treatment options with your doctor or specialist.

🚨 When to See a Doctor Immediately

Seek medical attention if you notice any signs of infection or delayed healing:

  • Increasing redness or warmth around the wound
  • A red streak spreading away from the wound
  • Worsening pain or tenderness
  • Pus or cloudy drainage
  • Foul odour from the wound
  • Fever or chills
  • Wound opening up or not progressing as expected

🧾 References

  1. Winter GD. Formation of the scab and the rate of epithelialization of superficial wounds in the skin of the young domestic pig. Nature. 1962;193:293–294
  2. O’Brien L, Jones DJ. Silicone gel sheeting for preventing and treating hypertrophic and keloid scars. Cochrane Database Syst Rev. 2013;CD003826
  3. Peres PS, et al. The influence of sunscreen use on scar pigmentation after surgical procedures. J Eur Acad Dermatol Venereol. 2018;32(9):e373–e375
  4. Mustoe TA, et al. Scar management: prevention and treatment of hypertrophic scars and keloids. Plast Reconstr Surg. 2004;114(6):139S–151S
  5. Sørensen LT. Wound healing and infection in surgery: the pathophysiological impact of smoking, smoking cessation, and nicotine replacement therapy. Ann Surg. 2012;255(6):1069–1079