Overview of 3 Types of Surgery Scars

Scars form any time a cut or incision is made in the skin. That's just a truth. Despite plastic surgeons' reputations for “scarless” healing, it comes from the surgeon's ability to camouflage or hide scars in inconspicuous places on the body.

Woman showing her scars

Peter Dazeley / Getty Images

All Surgery Produces Scars, Whether Internal or External

Scars are present but hidden or camouflaged. For instance, a tummy tuck incision is hidden at the lower part of the abdomen, which is normally covered by a bikini bottom, swimming trunks, underwear, or sometimes pubic hair. A facelift incision is hidden behind the ears. Liposuction incisions are hidden in the pubic area and the navel. Rhinoplasty incisions are hidden inside the nose. In an eye lift, also known as a blepharoplasty, the incision is hidden in the natural crease of the eyelid.

3 Types of Scars

Some scars heal as a fine line and become barely perceptible. Other scars become so noticeable, that it can significantly affect the quality of life of its bearer. Yet other scars fall somewhere in between—noticeable, but not enough to make you feel overly self-conscious.

If a scar heals poorly by becoming thick and raised it is often incorrectly categorized as a keloid or hypertrophic scar.In some cases, it may certainly be a keloid. More often than not, it is just a scar that has healed less than optimally and is not necessarily a keloid scar.

When a scar does not heal as a fine line, it can cause a great deal of anxiety. A scar that does not heal as a fine line will fall into one of three categories.

Flat and Widened Scars

An ideal scar is flat and thin. Scars may remain flat, but become widened with time. This is common in areas of constant motion, such as the knee area, the shoulder, and the back. Scars that are flat and wide can be camouflaged with makeup. Unless they are on a prominent part of the body, they do not usually cause a great deal of distress physically, emotionally, or psychologically for a person.

Raised and Widened: Keloid Scar

In order for a scar to be considered a keloid, it must have certain characteristics. A keloid scar stands out from the skin and is wider than the original incision. Keloid scars grow and spread resulting in unsightly firm nodules. They do not tend to shrink down with size and can cause discomfort in the form of pain and itching. Keloids can form on any area of the body, but the most common sites are the back, shoulders, ears, and chest. Keloid scars are the most difficult scars to treat. Treatments for keloid scars include excision (cutting it out), steroid injections, and application of pressure dressings.

Raised and Widened: Hypertrophic Scar

Some scars become raised above the level of the skin and wider than the original scar. If it maintains the shape of the original incision, it is known as a hypertrophic scar. They are often red or pink but can vary in color and sometimes appear darker or lighter.

They are often confused with keloid scars. While they look similar to keloid scars in some respects, they are actually quite different. Unlike a keloid scar, a hypertrophic scar will not spread beyond the borders of its original shape. It may actually shrink down in size after several years. Hypertrophic scars are more common than keloids. They are not as difficult to treat.

6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Marshall CD, Hu MS, Leavitt T, Barnes LA, Lorenz HP, Longaker MT. Cutaneous scarring: basic science, current treatments, and future directions. Advances in Wound Care. 2018;7(2):29-45. doi: 10.1089/wound.2016.0696

  2. Ziolkowski, N., Kitto, S. C., Jeong, D., Zuccaro, J., Adams-Webber, T., Miroshnychenko, A., & Fish, J. S. Psychosocial and quality of life impact of scars in the surgical, traumatic and burn populations: a scoping review protocol. BMJ open, 2019;9 (6), e021289. doi: 10.1136/bmjopen-2017-021289

  3. Tsai CH, Ogawa R. Keloid research: current status and future directions. Scars, Burns & Healing. 2019;5. doi: 10.1177.2059513119868659

  4. Mustoe TA. International scar classification in 2019. In: Téot L, Mustoe TA, Middelkoop E, Gauglitz GG, eds. Textbook on Scar Management. Springer International Publishing; 2020:79-84. doi: 10.1007/978-3-030-44766-3_9

  5. American Academy of Family Physicans. Keloids.

  6. American Osteopathic College of Dermatology. Keloids and Hypertrophic Scars.