Many gender affirming procedures including breast augmentation, facial feminization, butt lift or body feminization, create incisions on the skin, leading to scars. These scars could take a long time to heal. At Scar Protocol, Dr. Javad Sajan has created a scar protocol system, consisting of five phases (creams) to target not only your scars, but each phase of them.
In this blog, with the guidance of our board-certified surgeon, we will take you through the process of healing and how you can prevent scar discoloration or thickness.
This system is built around one simple idea. Your scar doesn’t heal in a streamlined way. It changes month by month. Instead of using one generic cream the entire time, this system gives your skin what it needs at each stage over the first year of healing.
From the moment your incision has fully closed through the final maturation of the scar, every phase focuses on hydration, comfort, and gradual refinement of texture and color. To target the scar in each phase, you need specific formulas.
Phase I begins once your incisions have fully closed and your surgeon clears you to start topical care. This usually marks around the one-week, though this can vary. At this point, the skin is still fragile and easily irritated. The goal here is gentle support, not aggressive treatment.
This phase pairs a mild cleanser with a lightweight cream so you can keep the area clean without stripping or scratching the new tissue. Soothing ingredients like aloe vera and vitamin E help calm redness and reduce that tight, itchy feeling many people notice around fresh scars. This is especially useful for long chest scars, donor sites, neck lines, and any area that bends or rubs against clothing.
As your body starts to build more collagen and your scar becomes noticeable on the surface, dryness and tightness often increase. Phase II steps in with a richer moisturizing cream designed specifically for developing scars.
Ingredients such as allantoin, glycerin, and aloe work together to keep the skin flexible and well hydrated. Soft, moisturized tissue is less likely to feel stiff or rope-like. This phase is particularly valuable for scars under compression garments (like top surgery scars), facial incisions that move when you talk or smile, and external genital or body incisions that experience friction. The goal is to help your scar move with you instead of pulling uncomfortably.
By the time you reach Phase III, your scar often looks redder or more raised as collagen continues to remodel beneath the surface. This is normal, but it’s also the perfect time to focus on intensive hydration and gentle renewal.
Here, the system introduces a cream formulated with purified white snail mucin. Snail mucin brings a mix of humectants, vitamins, and antioxidants that help soften the surface and support smoother texture as new tissue forms. This phase works especially well for highly visible areas: hairline and scalp incisions from facial procedures, tracheal shave scars at the front of the neck, and forearm donor sites that tend to feel dry and rough.
Even when a scar looks calmer on the surface, it continues to remodel internally for many months. Phase IV recognizes that healing is still active and provides a conditioning cream built for this middle stretch of recovery.
Using ingredients like vitamin E (tocopherol), salix alba, and coconut oil, this phase focuses on maintaining elasticity, comfort, and healthy-feeling skin. Long, linear scars on the chest, groin lines from bottom surgery, and larger donor areas often benefit from this ongoing moisture. You’re essentially “feeding” the scar the hydration and nourishment it needs while the deeper layers continue to reorganize.
The final phase concentrates on refining the appearance of a scar as it approaches the one-year mark. At this point, most scars have settled down but may still show uneven texture or mild discoloration.
Phase V introduces a retinol (vitamin A) cream used as directed to encourage gentle surface renewal. Retinol helps the outer layers of skin turn over more efficiently while deeper scar tissue continues to mature. For scars on the chest, face, neck, or donor sites that remain visible in daily life, this last step aims to smooth and even out the look of the scar as much as possible over time.
The 5-Phase Scar Protocol System is extra helpful because not only it works on your scar, it also provides a structured, time-based plan that aligns with your body’s natural healing cycle.
Before your surgery, you can follow these steps to prevent getting stubborn scars.
While prevention always helps, following are the tips you must follow after getting you gender-affirming surgery done.
If your scars remain raised, painful, or very visible even after several months of topical care, talk to your provider about inhouse treatments. Options can include:
Every scar tells a different story. From those stories and Dr. Sajan’s experience listening to patients worry about how their scars would look long after surgery, grew the scar protocol system. After years of answering the same questions and seeing how confusing scar care advice could be, he wanted a simple, structured way to guide people through healing. His goal was to turn his surgical knowledge and research into a practical system that helps patients feel supported.
If you want to explore our services or discuss your journey towards rejuvenated skin, call us at (425) 864-3777 or click here to place your order.
