Seeing mastectomy scars where you once had breasts can feel jarring. “I want to look like my normal self. It’s really hard on my self-esteem,” one MyBCTeam member wrote.

Many factors influence the appearance of mastectomy (breast tissue removal) scars, including the type of mastectomy, your overall health and genetics, and aftercare procedures. But it’s not all about looks — some mastectomy scars also feel numb or painful. Learn more about what’s normal, what’s not, and how to support your natural healing process.

What Do Mastectomy Scars Look Like?

Mastectomy scars vary in size and location based on the type of surgery you have.

• Lumpectomy or partial mastectomy — A small curved or straight scar over the site of the tumor
• Skin-sparing mastectomy — A straight line starting where the nipple and areola used to be, typically extending down or toward the arm
• Nipple-sparing mastectomy — Typically a large, slightly curved scar hidden under the natural fold of the breast or to the side
• Simple or total mastectomy — A large, straight scar extending across the entire width of your breast
• Modified radical mastectomy — A large, straight scar extending across the entire width of your breast and under the arm, with small and isolated underarm scarring

Some people choose to get breast reconstruction surgery after a mastectomy to restore a natural breast shape. This introduces additional scars around the breasts.

You can receive breast implants or use tissue from your abdomen, back, inner thigh, or upper glutes to shape a new breast. Large scars form where the tissue is removed.

What Mastectomy Scars Look Like as They Heal

Your body heals wounds (like mastectomy incisions) in distinct stages. Your scar will look different depending on its healing stage.

The First Few Days

In the hemostasis phase, your blood clots at the incision to form a protective scab. This continues for about 24 hours. Meanwhile, specialized cells arrive to clean the wound of bacteria and anything else that shouldn’t be there. This is called the inflammatory phase.

Inflammation is the body’s natural response to injury, and it can make your scar look pink or red or darker than your usual skin tone. This happens because the blood vessels around the wound widen to improve blood flow. Wider blood vessels allow more healing cells to quickly reach the wound. The increased blood flow is also more visible under the skin.

Around Day Three

Within a few days, the proliferation phase begins. In this phase, cells called fibroblasts begin producing the building blocks of new skin. The main building block is a protein called collagen.

At first, a very thin layer of collagen stretches across the incision. More layers are added over time, and the two sides of the incision should start to pull together (contract).

The proliferation phase lasts a few weeks. Some scars appear thick and red at this point, but that’s usually not the scar’s final form.

A Few Weeks In

Around the third week of healing, the body begins to rearrange collagen into a stronger network. This is called the maturation or remodeling phase. During this time, scars typically become thinner, flatter, and lighter.

It takes about one year for a scar to complete this final phase, but some people may heal faster or slower.

Long Term

Eventually, some scars fade to the point of being nearly invisible. However, this isn’t always the case with mastectomy scars.

“My scars dip in like a thin belt across my [chest],” one MyBCTeam member wrote. “You can see it under a cami or light sweater.” Another reported similar dips plus hard scar tissue after an infection.

Sometimes, visible mastectomy scars can affect your self-esteem. “I’m self-conscious of how my huge mastectomy scars look,” a MyBCTeam member shared. “It feels weird to be bare-chested while being intimate.”

Seeking emotional support after a mastectomy surgery can help you find confidence, no matter how your scars look.

Complications To Watch For

Sometimes complications arise during the healing process. Your wound may grow abnormally, never flatten out, or become infected.

• Abnormal growth — Scar tissue that spreads beyond the incision area is known as a keloid. These usually rise above the surrounding skin and appear discolored.
• Raised appearance — A discolored scar that remains within the bounds of the original incision but still rises above the surrounding skin is known as a hypertrophic scar.
• Infection — An infected scar or wound may feel increasingly painful, hot, and swollen. It may smell bad, leak pus or colored liquid, or cause fever, chills, nausea, or vomiting.

Infected wounds require prompt medical care. If left untreated, infections may get worse or spread to the bloodstream, causing a life-threatening condition called sepsis.

There’s no easy way to predict whether you’ll develop keloid scars or hypertrophic scars, but they seem more common in people with darker skin and people aged 30 or younger. Scars heal differently for everyone based on factors like age, genetics, current medications, past radiation therapy, or recent chemotherapy. Health conditions that restrict blood flow can also slow the healing process.

Talk to your care team to find out if you’re at risk for delayed healing and how you can best support your body after surgery.

What Does Mastectomy Scar Tissue Feel Like?

Many people don’t feel any pain or discomfort once their mastectomy scars heal. But for 20 percent to 68 percent of breast cancer survivors, pain lingers longer than three months after surgery. This is called postmastectomy pain syndrome, or PMPS.

One theory suggests that PMPS occurs when mastectomy scars form around nerve endings. This can cause numbness, stabbing pain, throbbing pain, weakness, burning, or pulling in the chest, the area below your armpit, and in the upper arm. In some cases, surgery can free these trapped or buried nerves.

Some people also report that their mastectomy scars cause tightness, pulling, or pain when performing certain movements. This happens because the skin surrounding the mastectomy incision pulls together and tightens as the scar forms. Tight skin can’t move fluidly with your muscles, so your motion may be restricted, and you may feel discomfort when the scar tissue reaches its limit.

Surgery can also help with this type of mastectomy scar pain.

Ongoing Mastectomy Scar Care

Your care team can advise how to care for your incisions immediately after surgery. Typically, you’ll need to keep the incision clean and dry. Don’t shower or take a bath until your surgeon says it’s OK.

Change bandages according to schedule, checking for signs of infection every time. Don’t touch or scratch the wound, and follow your surgeon’s directions about limiting your physical activity.

Taking good care of your scar in the days, weeks, and months following surgery may help reduce its appearance over time. Here are some common suggestions:

• Cover scars or use sunscreen when outside. Sun exposure can cause scars to thicken, harden, and become discolored.
• Gently massage the scar to break up the tissue and encourage more collagen remodeling. Check with your surgeon to make sure your wound has healed enough to tolerate this. Your care team may also refer you to a scar tissue physical or occupational therapy specialist.
• Use topical scar treatments for healthy healing. Ask your surgeon which products are safe for you.
• Apply a pressure bandage (with your surgeon’s permission) to decrease the size of the scar.
• Perform range-of-motion exercises to prevent tight scars.

A healthcare provider can also help you manage large, painful, or itchy scars through steroid injections.

If you’re struggling with the way your mastectomy scars look or feel, consider asking about surgical options. Sometimes breast reconstruction can help reduce the appearance of mastectomy scars and improve your self-esteem. Scar revision surgeries may also change the way the scar looks.

Your care team can help you weigh the pros and cons of each option.

Join the Conversation

On MyBCTeam, people share their experiences with breast cancer, get advice, and find support from others who understand.

How do your mastectomy scars look and feel? Let others know in the comments below.