A sternotomy incision runs 6 to 10 inches straight down the breastbone, and it stays under tension every time you breathe, cough, or reach overhead for months after open-heart surgery. Scar cream for sternotomy scars works best when it's silicone-based, applied consistently across the full incision length, and paired with sun protection through the scar's entire 12 to 18 month maturation window — not just slapped on for a few weeks and forgotten.

Why scar cream matters for open-heart surgery patients

A sternotomy sits on a high-tension zone. The sternum flexes every time the ribcage expands for a breath, and it flexes again with every cough, sneeze, or attempt to sit up unassisted in the first weeks of recovery. That constant pulling is a documented driver of hypertrophic scarring on chest incisions, more so than on low-tension sites like the forearm or shin.

Cardiac surgery patients also skew older and are frequently on blood thinners, both of which can slow wound healing and widen the eventual scar line. Add in that the collarbone and upper chest are among the most sun-exposed parts of the body once someone's back in a V-neck shirt or a cardiac rehab tank top, and you've got a scar with three separate risk factors working against it at once. A silicone-based scar cream addresses the mechanical and hydration side; sunscreen addresses the pigment side. Skipping either one leaves a visible gap in the routine.

Update your incision-care routine before you start any product

Start here, not with the cream aisle. A silicone product applied too early does more harm than good.

• Get explicit surgeon clearance that the incision is fully closed
• Confirm no open areas, drainage, or scabbing remain
• Wait for steri-strips to fall off naturally or be removed by your care team
• Never apply any product over exposed staples or sutures
• Check with your cardiac team if you're also managing a sternal wire or hardware near the surface

Clean the scar without disturbing fragile new tissue

Gentle cleaning keeps the incision from becoming a site for irritation or infection before silicone treatment even starts.

• Wash with a fragrance-free, non-abrasive cleanser and lukewarm water
• Pat the area dry with a clean towel — never rub
• Avoid fully soaking the chest (baths, hot tubs) in the first several weeks
• Skip exfoliating scrubs or washcloths directly on the incision line

Start silicone gel across the entire incision, not just the visible center

Once your surgeon confirms the incision is closed, a thin layer of silicone gel twice a day is the manual, low-cost starting point most scar clinics recommend before moving to sheeting. Rejûvaskin's silicone scar gel is formulated for exactly this stage — a fast-drying layer you can wear under clothing without staining fabric.

• Apply a rice-grain-sized amount and spread it thin, twice daily
• Cover the full incision, including the ends near the collarbone and the xiphoid
• Let the gel dry fully before getting dressed
• Reapply after showering or heavy sweating
• Give it 8 to 12 weeks before judging whether it's working

Add silicone sheeting once the scar can tolerate compression

Sheeting adds sustained pressure and hydration that gel alone doesn't provide, and it's the next manual step once the incision has closed enough to handle an adhesive strip. This is where most sternotomy patients move from gel-only to a combined routine.

• Choose a strip long enough to cover the full incision in one piece — a 1 x 22 inch silicone sheet is sized for most sternotomy scars without cutting and seaming shorter pieces together
• Work up to 12 to 23 hours of daily wear as tolerated, per standard silicone sheeting protocols
• Remove daily to clean skin and let it breathe for a short window
• Wash the sheet with mild soap and let it air dry between uses
• Reposition or replace the sheet weekly as adhesion wears down

Protect the healing scar from the sun every time it's exposed

A scar that tans or burns in its first year can darken permanently, and the upper chest is one of the easiest spots to forget.

• Apply SPF 30 or higher mineral sunscreen over the scar any time it's uncovered
• Reapply after cardiac rehab sessions, cycling, or outdoor walks
• Use a physical clothing barrier (higher neckline, light scarf) when sunscreen isn't practical
• Keep up sun protection for the full 12 to 18 month maturation window, not just the first few weeks

Track the scar month to month, not week to week

Sternotomy scars change slowly. Judging results after 10 days sets you up to quit a routine that was actually working.

• Photograph the scar monthly under the same lighting
• Note color, height, and texture changes at each check-in
• Flag scars that stay raised, itchy, or increasingly red past 3 to 4 months with your surgeon or a scar specialist
• Compare against your baseline photo from week one, not against someone else's scar online

Consider a paired kit once the wound is stable

For patients who don't want to manage gel and sheeting as two separate purchases, a combined kit removes the guesswork on sizing and timing. The Scar Heal Kit pairs silicone gel with a pre-sized sheet built for one incision length.

• Start the kit only after your incision has fully closed
• Follow the gel step during the day, sheeting overnight if daytime wear isn't practical yet
• Keep both components on the same 12 to 18 month scar-maturation timeline
• Replace the sheet component per the manufacturer's wear guidance, not indefinitely

Comparing scar cream and sheeting options for sternotomy scars

Verdict: for most sternotomy scars, Rejûvaskin's silicone scar gel covers the first 8 to 12 weeks and the 1 x 22 inch Scar Fx sheet takes over once the incision can tolerate daily compression. Both are Buy-rated for this segment; the choice between gel-only and gel-plus-sheeting comes down to how much daily wear time a patient can commit to.

Scar Fx sheeting sizes for chest incisions

Scar Fx Silicone Sheet - 1" x 22"

Full-length silicone strip sized for one continuous sternotomy incision.

$59.95

Scar Fx Silicone Sheet - 1.5" x 9"

Shorter, wider silicone sheet for partial incision coverage or spot treatment.

$46.95

Scar Fx Silicone Sheet - 4" x 8"

Larger sheet for wider chest coverage or a raised, thicker scar section.

$66.95

Common mistakes sternotomy patients make with scar cream

• Starting silicone too early. Applying gel or sheeting before the incision fully closes traps moisture against fragile tissue and can delay healing rather than help it.
• Only treating the visible middle of the scar. The ends near the collarbone and the lower point near the xiphoid process get skipped constantly, yet they're just as likely to thicken.
• Skipping sun protection because the scar is "mostly healed." A scar that looks pink and settled at 4 months is still inside its 12 to 18 month maturation window and can still darken from sun exposure.
• Judging results after two weeks. Silicone scar cream works over months, not days; switching products every 10 days never gives any single one a fair test.
• Reaching for a heavy, fragranced body lotion instead of a medical-grade formula. Fragrance and heavy occlusives can irritate incision edges that a purpose-built silicone scar cream is designed to avoid.

FAQ

One last thing

The lower third of a sternotomy scar, near the xiphoid process, tends to widen the most because that section flexes hardest during forward bending, lifting, and getting up from a chair. If you're only going to be consistent about one section, make it that one — that's where compression from silicone sheeting earns its keep over gel alone.

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