BACKGROUND? Postsurgical scars are of significant concern to patients and surgeons. Many studies have focused on different treatment options for established surgical scars. The prevention and minimization of such aberrant healing responses is more likely to yield better outcomes and require less time and expense. OBJECTIVE AND METHOD? A review of the literature on various forms of prophylactic treatments intended to prevent or minimize the development of prominent postsurgical scars was performed using the Pubmed database over a period from 1987 to 2010. Search terms included “scar prevention,” “scar minimization,” “post-surgical scar management,” and “surgical scars.” RESULTS? Various over-the-counter topical products commonly used by patients have failed to demonstrate any significant benefits in improving final scar outcomes. Numerous interventions performed around the time of surgery, including botulinum toxin, lasers, and intradermal injectable products, have shown effectiveness in minimizing eventual scar appearance. CONCLUSIONS? Patient education on proper wound care is a simple method of improving the cosmetic appearance of surgical scars. At the other end of the spectrum, our knowledge of the complex mechanisms of wound healing has allowed for the development of new, effective treatment modalities, including lasers, botulinum toxin, cytokines, and stem cells.