How do raised scars improve? Silicone, sun protection, steroids and scar revision
Updated: 4 days ago
Medical editor: Dr. Semih Yıldız, plastic, reconstructive and aesthetic surgeon (FEBOPRAS) · Last updated: October 2026
In the first months after surgery, it is often normal for a scar to look red, noticeable and slightly raised; this is not the scar's final appearance. A scar matures for up to a year: its colour fades, and it flattens and softens. Using silicone once the wounds have fully closed and protecting the scar from the sun are the foundation of scar care during this period. If the scar becomes clearly raised, we proceed step by step: first a short course of steroid cream, then a steroid injection if that is not enough, and a small scar revision if it has still not improved at the end of a year. A revision does not erase a scar; when a raised scar is re-stitched, it is roughly fifty-fifty whether it becomes thinner or returns to how it was before.
How a scar heals depends largely on the tension along the incision line and on your skin type. Where the incision runs is also part of the surgical plan; our breast lift and tummy tuck pages also describe where the scars lie. In this article, we have gathered our answers to the questions most often asked about scars after surgery.
My scar is still red months later; is this normal?
Yes. Scars look red and conspicuous in the first months; eyelid scars, for example, can stay red during this period despite silicone gel being applied regularly. The redness fades over time, and the scar continues to change for up to a year. Keep using silicone and protecting the scar from the sun throughout this time. Redness that fades slowly is not, on its own, a sign of a problem; we assess the final appearance of the scar at the end of a year. Redness that suddenly increases or spreads, swelling or discharge in a scar that had already started to fade is different, however; message us with a photo. Firm areas felt under the skin along the scar, or one side being tighter, are also part of healing; these usually soften within a year.
It is also a common worry that the scars on the two sides look different from each other. In a breast lift, the length of the crease under each breast is often slightly different; this is why the scars can also look slightly asymmetrical. Redness, small raised areas and puckering along the scar usually lessen over time. For where breast scars lie and how they heal, see Breast lift scars: around the areola, lollipop or anchor?.
When should I start using silicone?
Silicone is started once the wounds have fully closed. Areas with scabs or open wounds are treated with antibiotic cream, not silicone. On parts where the scab has come off and the skin has closed, however, you can start silicone; this means you may need to use both on the same scar for a while. Silicone can be used as sheets or as gel; your doctor will tell you which one to use.
While there are scabs or open wounds: antibiotic cream
Once the wounds have closed: silicone sheets or gel
Until the scar has matured: sunscreen together with silicone, and staying out of the sun as much as possible
If itching starts or the scar becomes raised: send us a photo of the scar; if necessary, we plan steroid treatment
My scar is becoming raised: do I need a steroid cream or injection?
Steroid creams are not used routinely after surgery. If the scar starts to become clearly raised, or if it is very itchy, we may recommend a short course of steroid cream depending on our assessment (for example a cream containing triamcinolone acetonide). We will tell you how long to use the cream; this is usually no longer than 1–2 weeks. For a raised scar, the steps are as follows:
Cream first: A short course of steroid cream can ease the raised area and the itching.
Injection if there is no relief: Steroid is injected into the raised scar with small needles to try to flatten it. If you are back in your home country, you can have this done by a dermatologist.
Revision if it has not improved within a year: The scar is treated again in a small procedure under local anaesthesia.
In a scar that has only just started to become raised, a single steroid injection can also help. Raised scar reactions to dissolving stitches, which are rarely seen in the lower eyelid, are dealt with in the same steps. If the scar is widening quickly, or if a new opening or discharge has appeared on it, let us know with a photo without waiting.
When can PRP, microneedling and laser be done?
In the first months, there is no need to push the scar with aggressive treatments. At our clinic, we do not perform laser treatment of surgical scars within the first year; we follow the same approach for raised scars. For other treatments, we wait for the scar to mature:
First months: silicone and sun protection; PRP (plasma prepared from your own blood) if you wish
After month 6: microneedling with a derma roller (can be combined with PRP)
After the first year: laser, tattooing directly over the scar and, if needed, the decision on scar revision
A tattoo on the skin near the scar, on the other hand, can be done 1 month after surgery. On darker skin, laser is used with more cautious settings; on skin that is prone to poor scarring, we avoid aggressive laser treatment.
Will a raised scar go away if it is re-stitched?
Raised and wide scars can be cut out and re-stitched; this is called scar revision. However, the result cannot be known in advance: there is roughly a fifty-fifty chance that the re-stitched scar stays thinner and flatter, and a fifty-fifty chance that it returns to how it was before. It is not possible to remove a scar completely; the aim of revision is to make the scar thinner. This is why we make the decision about revision by weighing up your expectations and the risks together.
Timing also affects the result. An intervention while the scar is still fresh and immature may be unnecessary, and it can also create new problems. In an area that looks fine today, changes such as scar widening or a reaction to dissolving stitches can also appear in the following months. This is why we usually plan a revision after a full year has passed and, if there is more than one problem, correct them in the same procedure. These procedures are mostly carried out under local anaesthesia, as day cases. For scars that have thickened as a result of a reaction to dissolving stitches, we use a different suture material during the revision. While waiting for the revision, silicone, sun protection and massage are continued.
Who has a higher risk of thick, raised scars?
Prominent scarring is rare, but in some situations it becomes more likely:
Dark and thick skin: The tendency towards raised (hypertrophic) scars and keloids is higher.
Having scarred poorly before: The same tendency persists with new incisions and after scar revision.
An incision closed under tension: Tension widens the scar; in a scar stretched by a larger implant, revision has a lower chance of success.
Smoking: It impairs wound healing and increases the risk of prominent scarring.
Genetic predisposition: Some people's skin forms thicker scars despite the same care.
We also take these risks into account in the surgical plan. On skin that is prone to poor scarring, we avoid techniques that leave a visible scar on the face (for example a direct brow lift performed just above the eyebrow) as far as possible. In a patient whose previous scars healed raised, we also discuss the benefits and drawbacks of a new operation in light of this risk, because the same risk remains despite every precaution. We explain where the tummy tuck scar will be and how it heals in Tummy Tuck Scar: Where It Sits and How It Heals.
How are depressed acne scars different?
A depressed acne scar involves a contour problem rather than simply a raised surface. Dr. Yıldız does not perform punch excision; when excision is appropriate, he prefers an elliptical excision for deeper, more pronounced problems. This replaces the depression with a surgical scar, rather than making the skin scar-free. Punch procedures can be discussed with a dermatologist.
Subcision releases tethering beneath the skin; fat grafting or filler can support lost volume. Dr. Yıldız may use subcision and fat grafting for partial improvement, particularly when depressions are widespread. The pits may not disappear completely, and this is his approach rather than a claim that one method is best for every acne scar.
Can several linear scars be replaced by one scar?
When several linear scars are confined to a relatively narrow, lengthwise area and the affected width of skin can be removed, scar revision may replace them with one surgical scar. This is not possible for every width or widely spread pattern, and it does not erase scarring. For someone with old self-harm scars, changing the pattern may also change how they relate to that reminder of the past. The value can extend beyond appearance, but psychological improvement is not guaranteed.
What if a scar is tethered to deeper tissue?
Surface appearance, deep tethering and lost volume are separate issues. Where deeper bands contribute to a depression, subcision may release them; fat grafting may support a volume deficit. The relevant distinction is release versus volume support, rather than assuming that cutting out the surface scar solves every problem. These options are assessed for the particular scar and tissue; an approach used for a depression after liposuction is not a universal treatment plan for all adherent scars.
Frequently asked questions
I have no open wounds left; can I start silicone?
Yes. If there are no scabs or open wounds left, you can start silicone sheets or gel. If there are still small scabbed spots, keep applying antibiotic cream to them until the scabs come off. Along with silicone, protect the scar from the sun as well.
Should I use a steroid cream after surgery?
Not routinely. Steroid cream is used only if the scar becomes clearly raised or very itchy, based on our assessment and for a short time. Before starting it on your own, send us a photo of the scar.
I have an old scar from a cut; will revision make it disappear completely?
No, it is not possible to remove a scar completely. Raised and wide scars can be cut out and re-stitched; however, there is roughly a fifty-fifty chance that the re-stitched scar becomes thinner, and a fifty-fifty chance that it returns to how it was before. What can be expected from revision is a thinner, flatter scar.
So that we can assess your scar, you can send us photos of it by message, taken in daylight, close up and from a little further away. Please also tell us how long ago the operation was, whether the scar itches or has become raised, and what you have used so far (silicone, cream, sunscreen).
This article provides general information and does not replace a medical consultation. Results vary from person to person.
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