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How do you perform scar massage after a mastectomy?

Abi Roxana Guerra, PT, DPT, CLT-ALM, Board Certified Clinical Specialist in Oncologic Physical Therapy

April 1, 2022

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Question

How do you perform scar massage after a mastectomy?

Answer

  • Prior to, assist the patient in performing desensitization of scar
  • May be the first time the patient has touched their scar
  • When the scar is healed, perform for the patient first

Here are some important areas to keep in mind with scar massage following a mastectomy.

  • Include patient in the treatment of scar massage
  • Identify if the patient is struggling with body issues
  • Encourage hygiene of scar
  • Scar mobilizations
    • Circles
    • Horizontal
    • Vertical

Scar massage helps with desensitization. I have had patients that have never even looked at their scars. Before scar massage, I take my clients into a room, dim the lights, and play nice, calming classical music. I ask them if they have ever seen or touched their scars before. I like to know this before I start touching their scars. It is important to have a conversation about it and be mindful that for some of them, it is the first time they are seeing their body without their breast tissue. Reinforce how important it is to desensitize that scar.

When the scars heal, perform desensitization for the patient first and include them. Some may say, "I don't want to touch it." Slowly, get them comfortable. Sometimes I perform the scar tissue massage and use their hand to guide them. I always ask permission first. You also want to identify if the patient is struggling with body issues. They have gone through trauma and surgery, but they also have changed their identity.

You also want to encourage hygiene of the scar as some clients are nervous about getting any water around it. After four to six weeks, as that scar is healing, we need to show them how to care for the scar.

For the massage, you perform circles and horizontal and vertical strokes for scar tissue mobilization. 


abi roxana guerra

Abi Roxana Guerra, PT, DPT, CLT-ALM, Board Certified Clinical Specialist in Oncologic Physical Therapy

Abi Roxana Guerra received a Bachelor of Science from the University of Texas at Austin in Nutritional Sciences. She obtained her Doctorate from The University of the Incarnate Word Physical Therapy School. Upon completion of Physical Therapy School, she embarked on her professional journey at MD Anderson Cancer Center in Houston, TX. Over the two years at MD Anderson, she found herself taking great interest in patients with cancer undergoing extensive treatment. This blossomed into taking and completing, the necessary steps to obtain credentialing as a Board Certified Clinical Specialist in Oncologic Physical Therapy. While feeling fulfilled in her career and in the patients she served, her close family ties to the South-West Region of Texas continued to call her home. Abi completed the challenge of developing a Cancer and Lymphedema program within the Rehabilitation Department at Uvalde Memorial Hospital. Abi has found a great opportunity to provide her knowledge and experience to an underserved region which she loves while pursuing her passion to serve those undergoing the toughest period of their lives.


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