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Scar Management

After breast surgery

Scars from breast surgery, whether a 'simple' lumpectomy or bilateral mastectomy can have a huge effect on your quality of life and overall pain level. Sometimes the scars are troublesome in themselves, with tightness in the chest and difficulty breathing deeply, and sometimes they seem trouble-free but are responsible for pain elsewhere in the body, such as tightness in the back, pain in the arms or lack of range of motion in the shoulders or neck. Breast surgery can even cause your hips to be uneven, impacting the spine and pelvis. Their trouble-making nature is not generally recognized, and the ensuing problems are treated as separate issues. It's not hard though, to picture how having the 'T-shirt of your birthday suit' tied in a knot could affect distant parts of your body through the connective tissue.


Through Cancer Services, HandSpring Bodywork offers a limited number of no-charge treatments per month, not just for breast cancer, but for any client of Cancer Services. Please contact them and ask for a SCAR THERAPY certificate for a no-charge session. 

"Two years after my lumpectomy, my portacath scar still looked bad. My surgeon wanted to revise it, but Nancy told me "I think we can do better than that." She treated my scar, and taught me what I could do for it myself. I'm so happy I took that route. It looks and feels fine now, and I didn't have to go through another surgery"


What’s the difference between undamaged tissue and a scar?

undamaged tissue

Smoothly gliding layers of normal tissue.

scar tissue

Scar tissue binds layers, inhibiting movement

This explanation is about external scars that are visible, even if sometimes hard-to-see. When surgery has been performed, or other damage has occurred, scar tissue forms not only on the skin but on all the internal wounds as well.

Undamaged tissue

There are many layers to our tissues. First, the skin, which is relatively thin; then superficial fascia, a fluffy fat-filled connective tissue; then deep fascia, a tough fibrous membrane; then muscle, and deeper still, depending on where on the body we are, bone and/or organs. All of these are connected by, enveloped and interwoven with connective tissue. Without damage or surgery, all these of layers are able to move freely, sliding over each other in whatever movement our body makes.

Damaged or Scarred Tissue

Collagen is the main component of that provides strength to healing wounds. Collagen is very strong, but not elastic. When not manipulated, a scar will typically be denser and less moveable than normal tissue.

The illustration shows the binding effect of a scar. Instead of sliding smoothly and easily over each other, the fascial layers are stuck down through the layers. This binding effect can restrict motion both nearby and in distant structures in sometimes subtle ways.

"Wound contraction is a normal part of healing and involves migration of wound margins toward the center. Some wounds continue to contract after closure, and a disfiguring scar or disability results. The ability of a wound to close depend in part on the flexibility of the surrounding skin. ... Contractures may interfere with joint mobility or with other body movements, such as breathing and head movement. They can occur in any area, in skin, and in subcutaneous tissue as well as after bone fractures and tendon, muscle, or nerve injuries.

Self Care

Self-Care for Scars   (Click here to download PDF version)

circular pressure

1. Firm circular pressure

sideways pressure

Without good mobilization, the tissue layers can stick together, restricting the movement of the fascia layers, and consequently can affect the movement of nearby joints and underlying or even distant structures. Once your wound has fully healed, it can be manipulated, even if it is painful at first. Gradually, with manipulation, the area will become less sensitive and more flexible.


Ways to improve a scar naturally


Even mature scars that are decades old can benefit and improve with regular manipulation. If you work with your scar daily, it will change rapidly in both appearance and comfort.


Although the scars illustrated are linear incision-based scars, these techniques will also work with large matted scars such as those from third degree burns or radiation therapy.

2. Sideways pressure

S-shaped pressure

3. S-Shaped pressure

skin rolling

4A. Skin rolling

skin rolling

1. Movement of tissue in a circular direction over underlying tissue or bone. You must use enough pressure to move the scar tissue. "Putting on lotion" pressure is not enough. All of these techniques will work better if NO lotion or lubricant is used, as the movement itself is what accomplishes your goal.

2. Sideways pressure. Be sure to go in both directions.

3. S-Shaped pressure. Do this in both directions, the whole length of the scar.

4. Skin Rolling. This also works very well for puncture wounds such as those for arthroscopic surgery. Pick up the loose layer of skin around the scar, and roll in all directions so that you're also picking up the scar itself.

Physical Manipulation of Scars - video

4B. Skin rolling


What Mechanical Link Does for Scars

hysterectomy scar

Hysterectomy scar 2 years after surgery and 24 Visceral Manipulation treatments, spread over 3 months.

improved scar

The same scar 2 years later after 6 Mechanical Link treatments. After the first Mechanical Link treatment, patient reported that her "bladder holds more, and empties more completely."

Having highly developed sensitivity in the hands, an ML practitioner can determine if a scar is causing a problem, and which part of the scar is contributing most to a dysfunction. Sometimes, it is not the scar itself, but the skin nearby which has been affected by the tensions created by the scar.

ML treatment of scars and skin is much faster, gentler, and less painful than the techniques shown above.

After treatment by recoil, the scar will gradually improve in appearance and rapidly improve in comfort. While the skin will never regain normal pigmentation, angry red scars will fade and although still visible and unpigmented, will move and feel like the rest of the body.

In the practice of ML the following correlations are frequently found: urinary tract dysfunction and chronic pelvic pain related to gynecological scars or appendectomy; neck pain related to face lift scars; frozen shoulder and other upper extremity problems related to heart or breast surgery right hip and/or knee pain related to appendectomy.

mature scar

Mature scar after liver surgery. Healing by second intention.

improved scar

The same scar, after 4 treatments, spaced months apart.

¹Pathophysiology:Adaptations and Alterations in Function, Barbara Bullock, R.N., M.S.N., Philadelphia: Lippincott 1996 p. 309

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