Bodies are messy. There is no getting around that, especially when you’re facing a major surgery like a hysterectomy. You’ve probably spent hours scouring the internet for photos of hysterectomy scars because you want to know what you’re in for. Honestly, the clinical diagrams they give you at the doctor’s office don't help much. They show neat little lines. Real life is different. Real life involves bruising that looks like a purple galaxy and incisions that might look a bit "angry" before they look better.
People get hysterectomies for all sorts of reasons—adenomyosis, fibroids that won't quit, or even life-saving cancer treatments. But no matter the reason, the physical mark left behind is often the thing patients worry about most in the weeks leading up to the procedure. It’s about more than just vanity. It’s about seeing how your body is going to change.
The different types of scars you might see
Not every hysterectomy looks the same. That's the first thing you notice when looking at galleries of survivors. If you’re having a laparoscopic surgery, you’re looking at tiny dots. Usually, there are three to five small incisions, each about half an inch long. They're often scattered across the abdomen—one in the belly button (the "stealth" incision) and a few others lower down.
Then there is the abdominal hysterectomy. This is the "open" surgery.
This one leaves a more significant mark. Most surgeons go for a horizontal "bikini cut," similar to a C-section scar, sitting just above the pubic hairline. It’s usually 4 to 6 inches long. In rarer cases, like when there are very large fibroids or certain types of cancer, a surgeon might have to do a vertical incision. This runs from the belly button down to the pubic bone. It’s the one people tend to be most self-conscious about, but it’s also the one that gives the surgeon the best access in a crisis.
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What to expect in those first few weeks
Early on, it’s not pretty. If you see photos of hysterectomy scars taken three days post-op, you’ll see Steri-Strips, maybe some surgical glue, or even staples. Staples are becoming less common, but they’re still used. The skin around the cut will be red. This is normal inflammation, but you have to watch for "spreading" redness or heat, which could mean an infection.
Healing isn't linear. One day it looks great, and the next day it’s itchy as hell. The itching is actually a good sign—it means the nerves are trying to figure out what happened. According to the American College of Obstetricians and Gynecologists (ACOG), the initial "knitting" of the skin takes about two weeks, but deep tissue healing takes months.
Don't panic if the scar looks raised at first. This is often just "puckering" from the internal sutures. Your body has several layers of stitches under the skin that you can't see. These are usually dissolvable, and as they disappear, the scar usually flattens out.
Realities of the "Hysterectomy Pooch"
Let’s talk about the thing nobody warns you about. The "swelly belly."
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If you look at photos of people a month after surgery, many of them have a little shelf or a "pooch" right above the incision line. It’s frustrating. You feel like you have a permanent muffin top. This happens because the surgery disrupts the lymphatic drainage in that area. Fluid gets trapped. For most people, this goes away after 6 to 12 months, but for some, a small "shelf" remains. It’s just part of how the tissue heals over the fascia.
Scar care: What actually works?
Everyone wants a magic cream. You’ll see influencers pushing expensive oils, but the science is a bit more boring.
- Silicone is the gold standard. Whether it's silicone gel or silicone sheets (like ScarAway), this is the only thing consistently backed by dermatological studies to flatten and fade scars.
- Sun protection is huge. If your scar sees the sun in the first year, it can permanently darken. This is called hyperpigmentation.
- Massage matters. Once your doctor clears you (usually at 6–8 weeks), massaging the scar helps break up adhesions. Adhesions are internal scar tissue that can make the area feel tight or even cause pain during movement.
Dealing with the emotional side of the mark
Some people see their scar as a badge of honor. It’s the mark of being pain-free after years of endometriosis. Others hate it. They feel it’s a reminder of a loss, especially if the surgery was for fertility issues or cancer. Both feelings are totally valid.
If you’re looking at photos of hysterectomy scars and feeling discouraged by the redness or the size, remember that these photos are usually snapshots in time. A scar at six months looks nothing like a scar at two years. Over time, most hysterectomy scars fade to a thin, silvery-white line that’s barely noticeable unless you’re looking for it.
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The color change is the biggest shift. Initially, the scar will be pink, red, or even purplish (especially on darker skin tones). Eventually, the blood vessels that were feeding the healing tissue recede, and the scar loses that pigment.
Actionable steps for your recovery
If you are currently preparing for surgery or are in the middle of healing, there are a few things you should do right now to ensure the best outcome for your skin and your sanity.
- Stop smoking. This is the big one. Smoking constricts blood vessels and is the number one cause of "wound dehiscence"—which is just a fancy way of saying your incision pops open. If you want a thin scar, your skin needs oxygen.
- Take "baseline" photos. Take a photo of your stomach before surgery, and then once a week after. When you're looking at yourself in the mirror every day, it feels like nothing is changing. Looking back at a photo from three weeks ago will prove to you that the swelling is actually going down.
- Support your core. Wear the abdominal binder if your hospital gives you one. It keeps the tension off the incision line. Less tension means the body doesn't feel the need to produce as much "tough" scar tissue, often resulting in a flatter scar.
- Wait for the "Okay" on creams. Don't put Vitamin E or Bio-Oil on an open wound. You have to wait until the skin is fully closed and the scabs have fallen off naturally. Putting oils on too early can actually trap bacteria and cause a localized infection.
- Watch the "tail" of the scar. Often, the very ends of the incision are the most prone to irritation because that’s where the knots of the internal stitches are buried. If you see a little "pimple" at the end of your scar, it might be a stitch reacting. Don't pop it; call your nurse.
Healing is a long game. Your body just had a major organ removed, and the scar is just the surface-level evidence of that massive internal transition. Give yourself a year before you judge the final result. Most of the time, the "scary" look of a fresh incision is just a temporary phase on the way to a much more subtle reality.