Aim: (1) To visually assess scarring of the gingiva and alveolar mucosa 1 year following apical surgery in the aesthetic zone; and (2) to evaluate whether scarring correlated with patient-related or surgical parameters. Material and methods: The material included 72 cases in the anterior maxilla. Three observers, who were blinded to the incision and flap design, independently assessed scar formation of the soft tissues. Each observer determined a pretreatment and a 1-year follow-up score of scarring, and mean changes were calculated. Results: With regard to the gingiva, the type of incision had a significant (P = 0.0013) influence on scar formation; that is, submarginal incisions and papilla-saving incisions produced more scarring than intrasulcular and papilla-base incisions. Scarring of the alveolar mucosa was significantly (P = 0.0108) influenced by the type of surgery (first-time vs. re-surgery) and by gender (P = 0.0496); that is, less scar formation of the alveolar mucosa was observed in re-surgery than in first-time cases as well as in male compared with female patients. Conclusions: Scar formation of the gingiva appeared to be influenced by the incision technique and use of antibiotics, whereas scar formation of the alveolar mucosa was correlated with gender and type of surgery. Possible scar formation should be discussed with the patient before surgery.