What to Know About C-Section Massages

Medically reviewed by Cordelia Nwankwo, MD

C- section scar massages can aid in the healing process and improve scar appearance. It is important to wait to begin massage until your healthcare provider gives you the go-ahead.

A cesarean section (C-section) is a surgery to deliver a baby and results in a scar across the mother's abdomen. About one in three women in the United States deliver their babies via C-section.

This article will describe the benefits of C-section scar massage and how to do it properly.

<p>Michael Nesterov</p>

Michael Nesterov

Related: Scar Tissue Massage and Management

Should I Massage My C-Section?

Although you cannot get rid of a C-section scar completely, you can promote scar healing and prevent complications by caring for it. One such way to do this is through scar massage.

Scar massage is known to improve the look of a scar. Massaging your C-section scar can help flatten and soften the scar over time. Massage has also been found to decrease pain, itching, and hyperpigmentation at the incision site.

Massaging the skin around the scar helps loosen scar tissue and improve skin tightness and elasticity. This can help prevent cesarean "shelf belly," in which flesh hangs over the scar. Furthermore, massaging your scar increases blood flow to the area. This aids in collagen formation, which helps a scar heal faster.



Takeaway

With your healthcare provider's approval, you can start C-section scar massage as soon as your incision has completely closed and no scab remains.



Related: Massage Therapy: What You Should Know

Types of C-Section Scars

C-section scars are usually about 4 to 6 inches long. At first, they appear pink and swollen. Over time they become flattened against the skin. The two types of C-section scars are:

  • Transverse C-section scar: This is the most common type of C-section scar. It runs horizontally along the lower belly, usually along the underwear line.

  • Vertical C-section scar: This type of scar is often used during emergency surgery because it allows the healthcare provider to remove the baby as quickly as possible. A vertical scar typically runs up and down from the belly button to the pubic line.

Compared to transverse c-section scars, vertical scars are associated with more risks and complications in terms of wound healing.

While there is clear research in support of massage for transverse C-section scars, very few studies explore the effects of massage for vertical C-section scars.



Takeaway

If you have a vertical C-section scar, it's especially important to discuss C-section massage with your healthcare provider before getting started. Your provider will ensure your scar has healed properly and is in a good state to benefit from C-section scar massage.



Related: How to Prevent or Minimize Surgery Scars

How to Massage Your C-Section Scar

Seven layers of tissue are cut during a C-section procedure, including skin, connective tissue layers, abdominal muscles, and the uterus. C-section scar massage should gradually target each of these layers to yield the best results.

C-section scar massage involves mobilizing these tissue layers in three parts—the superficial skin and fat layers, the muscles and connective tissues, and the deep tissues.

During the first few weeks of massages, you may only be able to work the superficial layers of skin and fat comfortably. As time passes and the scar tissue becomes less tender, you can start to apply deeper pressure.

C-section scar massage should be done while lying down with a pillow under your knees to ease any tension around your C-section scar. Some people prefer to lie on their back with their knees bent.

To get started, dip your fingertips in a gentle oil that is good for tissue repair. Olive oil, coconut oil, and jojoba oil are all great options due to their anti-inflammatory, antioxidant, and wound-healing properties.

Related: How to Use Hemp Oil for the Skin

Layer 1: Skin and Fat

The first portion of the massage targets the superficial skin and fat layers. Start by placing the pads of your fingertips just above the scar line.

Gently move the skin up and down, side to side, and in circles to get a feel for how tight and tender the tissues are. Notice if there is more resistance when you move your skin in a certain direction. If so, spend some time gently massaging in this direction to stretch and loosen up the scar tissue.

From there, you can massage the skin under the scar line in a similar fashion. If you find a tight spot, stretch and hold the skin for a few breaths.

During the first three to six weeks of healing, the scar line may feel painful and tender. Focus on massaging the skin above and below the scar line to start. As the tissues become less tender, you can start to massage the scar line itself.

Once you feel ready to massage the scar line, gently pinch the scar and lift the skin, then roll the scar line between your fingertips like a pencil. You can also move the scar and surrounding skin up and down and side to side to improve tissue mobility.



Takeaway

It is normal for the scar area to feel a bit uncomfortable during the massage, but it should never feel painful. Only apply a comfortable amount of pressure, and lighten up on the pressure if you feel pain.



Layer 2: Muscle

Beneath the superficial skin and fat layers are your abdominal muscles and connective tissues. To target them, you'll need to apply deeper pressure into your abdomen, above, below, and on top of your scar.

To massage the muscle layer, press the pads of your fingertips into the skin area surrounding the scar until you feel your abdominal muscles. Move your finger pads up and down, side to side, and in small circles while maintaining adequate pressure.

If any side of your scar feels tight, gently stretch the skin and muscle until you cannot comfortably stretch it more. Hold your fingers at the top of the stretch for a few counts or until you feel the tissues softening.

Take care not to force your muscle tissues beyond what is comfortable, as this can damage the healing tissues fibers. If your pain level allows it, you can pinch your scar line as deep as the muscle layer and roll the tissues between your fingertips.

Layer 3: Deep Tissue

Once you are ready, you can begin to massage the deepest layers of your abdomen. If a healthcare provider has ever applied deep pressure into your abdomen to check for appendicitis or kidney problems—that is the level of pressure to aim for.

To target the deep tissue layer, lie comfortably on your back with a pillow supporting your knees so that your abdominal tissues are fully relaxed.

Press your finger pads as deep into your abdomen as you comfortably can. Like the first two layers, massage your fingers in up and down, side to side, and circular motions, both above and below the scar. If one area feels tight, stretch the tissues and hold until you feel the tissues soften.

If your scar line feels ready, go ahead and roll it between your fingers, as deep into your abdominal tissue layers as you can.

Dense scar tissue in this region can restrict blood flow to your bladder, which can lead to bladder injuries and urinary complications in some women. To help reduce excess scar tissue formation, massage the full area between your scar and pelvic bone.



Takeaway

Aim to massage your scar for 10 minutes twice per day for at least six weeks. Then switch to massaging the area about three to four times per week until the scar has lost its coloring and becomes flattened.



When to Start C-Section Scar Massage

Before beginning C-section scar massage, talk with your healthcare provider. Most healthcare providers recommend waiting four to six weeks after surgery to begin a regular massage routine. The scab from your scar should be gone before beginning massage.

C-Section Scar Healing Stages

There are three main stages in the scar-healing process:

  1. The inflammatory stage lasts for three to five days after surgery. During this stage, the bleeding has stopped, and the scar appears pink and swollen. This is when platelet cells and white blood cells travel to the incision site to stop bleeding and help protect against infection.

  2. The proliferative stage lasts about five to 15 days. This is the time when collagen forms at the incision site. The collagen acts to pull together the edges of damaged skin along the incision. During this stage, new blood vessels form, and the scar appears thicker.

  3. The remodeling stage, which is the final stage of the healing process, can last for up to a year. During this stage, the scar flattens against the skin and fades in color.

When to Avoid C-Section Scar Massage

It’s important to talk with your healthcare provider before beginning a daily scar massage routine. Avoid C-section scar massage if the scar:

  • Is less than three weeks old

  • Is an open incision or cut

  • Shows signs of infection, such as increasing pain, redness, or pus drainage

  • Has any complications

  • Is older than 18 months (a massage at this point will likely not be effective)



Is it too late to start massaging my C-section scar?

A surgical scar is considered fully mature after 12 to 18 months. At this point, C-section scar massage will no longer benefit you. If a year has passed and you are unhappy with the texture or appearance of your scar, laser therapy or surgical scar revision may be considered.



Other Ways to Care for Your C-Section Scar

In addition to C-section scar massage, you can also use the following methods to help your incision heal:

  • Walk every day: Walking promotes healing by increasing blood flow. Walking also reduces the risk of blood clots and constipation.

  • Moisturize the incision site regularly: Ask your healthcare provider which moisturizer is best for you. They may recommend petroleum jelly or an antibiotic ointment once the wound has closed.

  • Change your surgical dressing regularly: Change the dressing at least once per day or anytime the dressing becomes wet or dirty.

  • Ask your provider about silicone therapy: Silicone gels and sheets keep the incision site hydrated, reduce itchiness, protect against infection, and help the scar heal softer and flatter.

  • Protect your scar from infection: Clean the incision site at least once per day and every time you change the dressing. Gently wash your scar with a mild antibacterial soap and water. Avoid scrubbing the area.

Additionally, there are some things you to avoid:

  • Avoid direct sunlight: Don't expose your scar to the sun. Scars are very susceptible to damage from UV rays for the first 18 months after surgery. Keep your scar covered any time you are outdoors.

  • Avoid heavy lifting: While your scar is healing, avoid lifting anything heavier than your baby. You should also avoid rigorous exercise until your healthcare provider gives you permission.

  • Avoid having sex: Don't have sex until your healthcare provider says you can.

  • Avoid soaking in water: While showering is okay, you should avoid soaking in pools or hot tubs until your healthcare provider gives you the green light.

  • Avoid using tampons or douches: Wait until your six-week postnatal check to start using tampons. Be sure to get your healthcare provider's permission first. Douches are not recommended at any time.



How do you treat an infected C-section scar?

Call your healthcare provider if you are concerned that your C-section scar has become infected. Possible symptoms of an infection in the incision include increasing pain, redness, swelling, pus, foul-smelling drainage, and a fever.



Related: Signs of Infection After Surgery

Summary

C-section scar massage is a helpful way to promote healing and improve the look and feel of your scar. Once your incision has healed and you are at least three weeks past your surgery, talk with your healthcare provider about starting a regular scar massage routine. Keep the scar moisturized and use gentle pressure to make small circles along the line of the scar. It is also helpful to massage the skin surrounding the scar.

Read the original article on Verywell Health.