If you have undergone a c-section when giving birth to a baby, you may be concerned and wondering when to start scar tissue mobilisation or massage after the scar has fully healed.
As a woman who has undergone two c-sections and after witnessing a few women who come to radiology my field of work for advice.
I write this article based on my own experience and of course I have relied on medical studies published worldwide on the subject. (All references at the end of the article).
Happy reading!😀 and feel free to ask questions in the comments or share your own experience.🙏
Last updated: August, 2025. Written by Juliet S, a diagnostic radiographer.
| Summary: Scar mobilization or massage for a C-section incision should ideally begin around 6-8 weeks postpartum, once the wound has fully closed and healed, and with the guidance of a healthcare professional. |
The number of performed caesarean sections is continuously rising in the whole world. In the United States, the average C-section done in 2007 was over 30% In 2010, in China, it reached up to 60%, while in the private sector in Brazil it was near to 80% and in the UK it’s over 50%. And so many other countries (Donnez,2017)
Some of us who have had more than one C-section, we normally require a fast recovery and support after C-section because we have not only to take care of ourselves but also the new-born.
There is usually moderate to severe postoperative pain after a c-section, and this will differ from individual basis.
Pain after a c-section can influence the postoperative recovery process and impact mobilization, early bonding between mother and child, and establishment of breastfeeding.
The truth is not many women, after having a c-section, are told about the impacts of a C-section scar and the effects it can have on their body long after the wound has healed.
▶️What is scar mobilisation (scar massage)
Before looking at the benefits of scar mobilisation, what is scarring on the skin.
🟤Scarring is part of the body’s natural healing process after tissue is damaged through surgical cuts or injuries during the operation
🟤When the skin is injured, our bodies produce a protein called collagen which builds up where the tissue is damaged, helping to heal and strengthen the wound.
🟤New collagen continues forming for several months and the blood supply increases, causing the scar to become raised and lumpy.
🟤In time, some collagen breaks down at the site of the wound and the blood supply reduces. The scar will usually become gradually smoother and softer.
Although scars are permanent, they can fade over a period of up to 2 years and this will depend on your age and skin type. It’s unlikely they’ll fade any more after this time.
▶️What are some of the issues concerning scar tissue, women who have had a c-section normally complain about
Usually when you have had a c-section, you will have an appointment within 4 weeks of the operation to check and see how the scar is healing.
In some countries such as the UK, the midwife will come to visit you at home to check on you and the baby.
However, before that, if you experience any pain, discomfort and worries, you are advised to see your doctor immediately.
A study that was done by (Gilbert et al 2022) that looked at scar tissue quality, healing and pain for women aged 18 to 40 years who had undergone at least one C-section.
Participants reported seven scar tissue things that they faced post c-section.
♦️ Pain, itching, colouring, stiffness, thickness, irregularity and others had overall opinion, each item was scored on a scale of 1 to 10.
They felt increased pain when pressure was applied to the C-section scar and painful scar especially when turning in bed.
My own experience!
It is now 8 years since I had a c-section. I still feel some kind of discomfort around my scar when turning positions in bed, yet the scar was well healed.
Any one with the same experience, tell us in the comments section!
▶️Benefits of Scar Mobilization:
Women who use scar massage after healing from a c-section, highlight a number of benefits.
According to a systematic review and meta-analysis done on women who have had a c-section to assess the effects of physical scar treatments on pain, pigmentation, pliability, pruritus, scar thickening, and surface area.
Who used physical scar management massage or soft tissue mobilisation on scar tissues did show a significant positive effect to influence pain, pigmentation, pliability, pruritus, surface area, and scar thickness compared with control or no treatment.
Deflorin,2020
Scar massage has been known:
🟠To soften and flatten scars: By encouraging collagen remodelling, making it less noticeable and improving its appearance.
🟠To decrease stiffness and to reduce any kind of scar discomfort by softening the scar tissue, increasing its flexibility, and improving the range of motion in the affected area, especially important when scars are near or across joints.
🟠Reduce adhesions: scars develop both on and below the skin to underlying structures such as muscles and joints which are called adhesions. These affect the flexibility and mobility of the structures in all the layers affected. So, massage helps to reduce the adhesions.
🟠Alleviate itching and over-sensitivity in areas that may have become numb or less sensitive due to scarring.
🟠Improve blood flow and circulation in the area, which promotes healing and the realignment of collagen fibers.
🟠Potentially reduce long-term problems particularly in the early stages of healing, like persistent tightness, pain, and limited movement.
Gilbert,2022
▶️When can you start scar mobilization?
The clinical practice guidelines that are available to support scar massage as a conservative treatment of postsurgical scars mobilisation lacks consistency about when to initiate treatment, the optimal technique, and dosage.
This might be a barrier to the integration of this therapy into current practice (Monstrey,2014)
The truth is some women who have had a c-section are not given any information about scar massage, or they even heal without a scar massage.
So, whether you do not have a scar massage mobilisation or have one, there is no harm, your scar will heal well.
Scar mobilization, also known as scar massage, can generally begin once the wound is fully healed and there are no scabs or openings.
Images showing 3 months after the c-section operation. This was a first caesarean during a second pregnancy
This typically occurs around 6-8 weeks after surgery or injury, but this will differ from everyone. For example, in my case it took nearly 3 months for my scar tissue to heal because it got infected.
It’s always crucial to consult with a healthcare professional for personalized guidance before you start any scar massage.
▶️Key pointers before you start any scar massage after a c-section.
Scar mobilisation techniques and gentle massage after a C-section aim:
⚪To improve tissue mobility.
⚪Reduce pain and discomfort.
⚪Promote optimal healing.
Some of the scar mobilisation techniques that are normally recommended when you have healed well with no pain from your c-section are:
1️⃣ Superficial Massage:
Begin by gently massaging around the scar, avoiding direct pressure if it’s too sensitive. Use the pads of your fingertips to make small, circular motions, moving up and down, side to side, and in circles.
2️⃣Deeper Massage:
As the scar becomes less tender, you can apply more pressure, gradually moving your fingers into the deeper layers of tissue. Continue with the circular, up and down, and side-to-side motions.
3️⃣Rolling Technique:
Once comfortable with deeper massage, try gently rolling the scar between your fingers.
Scar Mobilisation Techniques:
4️⃣ Slide and Glide:
Gently slide your fingers across the scar, focusing on loosening adhesions between skin layers.
5️⃣Circular Motions:
Use small, circular motions to soften the scar’s surface and address symptoms like itching or redness.
6️⃣Zigzag Strokes:
Gently move your fingers in a zigzag pattern across the scar to improve elasticity and mobility.
7️⃣Scar Lifting:
Carefully lift the scar tissue between your fingers, mimicking a gentle combing motion. This technique should be used once the scar is fully healed.
Don’t be afraid to experiment and find what works best for you. But make sure the wound is fully healed and there are no scabs or openings
For some women, touching the c-section scar can trigger a traumatic experience preventing them from being able to massage the scar. If you are one of these women, you are not alone, and it is understandable.
You can start from touching a scar on top of your clothes to help you build up to direct touch
▶️Important Considerations to help you achieve a good scar mobilisation message.
⚫Listen to Your Body:
Massage should be firm but not painful. Stop if you experience sharp pain or discomfort. Do not rush into anything you do not feel comfortable with. Give yourself time to get comfortable with the way it looks and feels.
⚫Breathing: Focus on your breath during massage, which can help relax the muscles and promote tissue release.
⚫Consistency: Regular, gentle massage is key to achieving optimal results.
⚫Professional Guidance: If you have any concerns or experience persistent pain, consult with a healthcare professional or physical therapist.
⚫Skin Care: Keep the scar clean and dry. You can use scar treatments as recommended by your healthcare provider.
⚫Sun protection: While your scars are healing, you should avoid sun exposure which may cause your scars to hyper-pigment or turn darker than the surrounding skin.
Monstrey,2014
▶️How long to massage C-section scar
The length of a c-section scar massage will depend on individual basis.
Caesarean section scars can lead to pain and tightness which can impact your abdominal strength, blood flow to the area, posture, hips and back.
Sometimes these problems can start immediately after surgery but sometimes onset can be more insidious and can start weeks, months or even years post-surgery.
⚫Massage can help to increase scar tissue mobility and elasticity, reduce muscle restriction, reduce numbness and improve sensation around the scar.
⚫It also improves healing process and its appearance, reduce pain, itching and sensitivity around the scar area, prevent the size of the scar from increasing.
| Massage is particularly effective in the first 6 months postpartum, however you can still benefit from the scar massage, even if it has been months or years since you had a C-section |
Aside from that, it can take up to 2 years for the scar to fully reduce and reach the maturation process.
How long or regularly to massage a scar will depend on how you feel in the way of recovery and energy
♦️Some people begin with 5 minutes of massage daily until the tissues are freely moving in all directions.
♦️Then reduce to a weekly massage, if you notice any stiff or tight areas, then work with them.
Scar massage can be done lying down on a bed with your knees bent or completed in the shower or bath if that is more convenient.
▶️Why does my C-section scar feel like it’s pulling?
A C-section scar can feel like it’s pulling due to the formation of scar tissue, which can be less elastic than normal skin and may restrict movement.
This pulling sensation can be exacerbated by muscle separation (diastasis recti) or weakness in the abdominal and pelvic floor muscles.
When the body repairs a surgical incision, it creates scar tissue, which is made of collagen fibers. In healthy skin, these fibers are arranged in a multidirectional pattern, making it elastic.
In scar tissue, the fibers tend to be aligned in a single direction, which can make the scar tissue less flexible and more prone to feeling tight or pulling
While some pulling is normal during the healing process of C-section recovery, gentle massage and movement can help improve flexibility and reduce these sensations.
However, persistent or severe pulling, especially with other symptoms like redness, swelling, or pain, should be evaluated by a healthcare professional.
Who will assess the scar and the surrounding tissues, rule out any complications, and recommend appropriate treatment, such as scar massage or physical therapy to address muscle weakness or adhesions.
▶️How to flatten a C-section scar after 2 years?
Some people do feel uncomfortable with protruding scar tissue even after years of healing and massage treatments.
You will have to consult a doctor to help you acquire professional treatment such as
♦️Steroid injections: If the scar is raised, particularly hypertrophic or keloid scars steroid injections can help flatten the scar, reduce redness, itching, and tenderness.
These injections work by breaking down collagen fibers and reducing inflammation (Chua,2019)
♦️Laser therapy can help reduce redness, soften scar tissue, and improve the overall texture of the scar, making it less noticeable (Karmisholt,2017)
♦️Scar revision surgery: If other methods are unsuccessful, your doctor might recommend scar revision surgery to remove and re-stitch the scar.
This helps to create a smoother, flatter, and less noticeable scar. It can also address functional issues like pain or restricted movement caused by the scar
▶️Steps to help speed up the healing of a c-section wound scar
To promote healing of a C-section scar, I will share with you advice I was given after I had two c-section. which was very helpful during my recovery.
Wound care
➡️keep the wound clean and dry.
➡️Try to wear loose clothing.
➡️Avoid soaking while taking a bath or swimming until your doctor gives you a go ahead.
Manage pain and discomfort
➡️Manage pain with appropriate medication given to you by your doctor.
➡️Try to support your scar area with your hand or towel while coughing, sneezing and laughing.
➡️Try to get as much rest as it will help with your healing.
Scar massage and movement
➡️Gentle massage with a non-perfumed cream or lotion, alongside as we have discussed.
➡️Exercises like pelvic tilts and knee rolls, can also help improve scar mobility and flexibility.
➡️Exercise can improve circulation and muscle tone, which can indirectly help with scar appearance. But do this when you are well healed.
➡️Avoid heavy lifting, strenuous activity, and prolonged standing for the first few weeks.
| Always be patient, healing can take 4 to 6 weeks or more: It takes time to see results from scar treatments. Try to maintain healthy habits and return to activity gradually. |
We have come to the end of this article, wishing you a quick recovery, look after yourself and baby!🙋
Any experience lets meet in the comments section below.
📚Sources:
Betran AP, Ye J, Moller AB, Souza JP, Zhang J. Trends and projections of caesarean section rates: global and regional estimates. BMJ Glob Health. 2021 Jun;6(6):e005671. doi: 10.1136/bmjgh-2021-005671. PMID: 34130991; PMCID: PMC8208001.
Roofthooft E, Joshi GP, Rawal N, Van de Velde M; PROSPECT Working Group* of the European Society of Regional Anaesthesia and Pain Therapy and supported by the Obstetric Anaesthetists’ Association. PROSPECT guideline for elective caesarean section: updated systematic review and procedure-specific postoperative pain management recommendations. Anaesthesia. 2021 May;76(5):665-680. doi: 10.1111/anae.15339. Epub 2020 Dec 28. PMID: 33370462; PMCID: PMC8048441.
Gilbert I, Gaudreault N, Gaboury I. Exploring the Effects of Standardized Soft Tissue Mobilization on the Viscoelastic Properties, Pressure Pain Thresholds, and Tactile Pressure Thresholds of the Cesarean Section Scar. J Integr Complement Med. 2022 Apr;28(4):355-362. doi: 10.1089/jicm.2021.0178. Epub 2022 Jan 13. PMID: 35426735; PMCID: PMC9051872.
Monstrey S, Middelkoop E, Vranckx JJ, Bassetto F, Ziegler UE, Meaume S, Téot L. Updated scar management practical guidelines: non-invasive and invasive measures. J Plast Reconstr Aesthet Surg. 2014 Aug;67(8):1017-25. doi: 10.1016/j.bjps.2014.04.011. Epub 2014 May 14. PMID: 24888226.
Stupak A, Kondracka A, Fronczek A, Kwaśniewska A. Scar Tissue after a Cesarean Section-The Management of Different Complications in Pregnant Women. Int J Environ Res Public Health. 2021 Nov 15;18(22):11998. doi: 10.3390/ijerph182211998. PMID: 34831752; PMCID: PMC8620716.
Donnez O, Donnez J, Orellana R, Dolmans MM. Gynecological and obstetrical outcomes after laparoscopic repair of a cesarean scar defect in a series of 38 women. Fertil Steril. 2017 Jan;107(1):289-296.e2. doi: 10.1016/j.fertnstert.2016.09.033. Epub 2016 Nov 2. PMID: 27816234.
Deflorin,C ,Hohenauer,E, Stoop,R Daele,V Clijsen,R ,Taeymans,J Physical Management of Scar Tissue: A Systematic Review and Meta-Analysis. The Journal if alternative and complementary Medicine. Volume 26, Number 10, 2020, pp. 854–865Mary Ann Liebert, Inc.DOI: 10.1089/acm.2020.0109854
Chua SC, Gidaszewski B, Khajehei M. Efficacy of surgical excision and sub-dermal injection of triamcinolone acetonide for treatment of keloid scars after caesarean section: a single blind randomised controlled trial protocol. Trials. 2019 Jun 18;20(1):363. doi: 10.1186/s13063-019-3465-6. PMID: 31215471; PMCID: PMC6582563.
Karmisholt KE, Taudorf EH, Wulff CB, Wenande E, Philipsen PA, Haedersdal M. Fractional CO2 laser treatment of caesarean section scars-A randomized controlled split-scar trial with long term follow-up assessment. Lasers Surg Med. 2017 Feb;49(2):189-197. doi: 10.1002/lsm.22606. Epub 2016 Nov 8. PMID: 27862066.
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