Background <p>Prior studies report patient dissatisfaction regarding scarring following breast surgery, highlighting the importance of patient education and expectation management. This study examines representation of visible scarring within breast surgery patient education materials.</p> Methods <p>A cross-sectional analysis of online materials was conducted using data from academic hospitals with plastic surgery residency programs (<i>n</i> = 105) and the American Society of Plastic Surgeons (ASPS) webpage. Materials were examined by surgery category: breast reconstruction, augmentation, and reduction. The primary outcome was the type and percentage of materials showing visible scars. Chi-square tests and multivariate logistic regression were utilized for statistical analysis. Fleiss’ kappa scoring was utilized to assess interrater reliability.</p> Results <p>Of the academic websites containing patient media (34.3%), 69.7% depicted visible scars. ASPS materials included patient media for each category, with 41.5% depicting visible scars. Across ASPS and academic websites, visible scarring was displayed in 69.6% of breast reconstruction, 23.2% of breast augmentation, and 84.2% of breast reduction media. Chi-square analysis revealed a significant difference when comparing the two sources for breast augmentation materials (<i>p</i> &lt; 0.01). Multivariate logistic regression revealed a significant interaction between source and breast surgery categories (<i>p</i> &lt; 0.01). The Fleiss’ kappa score was 0.79, indicating substantial agreement among six researchers (<i>p</i> &lt; 0.01).</p> Conclusions <p>This study highlights a gap in the representation of post-operative scarring within breast surgery patient education materials. These findings underscore an opportunity to improve the realism and availability of breast surgery education materials, potentially helping to manage pre-operative expectations and increase post-operative satisfaction.</p> <p>Level of evidence: Not ratable.</p>