How does massage for scars influence the scar maturation process?

After a surgical incision, the skin goes through inflammatory, proliferative, and remodeling phases, with collagen remodeling that can last up to 24 months. Mechanical stimulation of the tissue through massage provides controlled distraction and shearing that:

• Reorganize collagen fibers and reduce overproduction (mechanotransductive effect on fibroblasts),
• Improve edema drainage and local vascularization,
• Desensitize nerve endings, reducing itching and pain,
• Prevent adhesions between skin, fascia, and muscle planes, preserving mobility.

A systematic review with meta-analysis of 32 controlled trials found moderate to strong effects of physical management (including massage) on pain, itching, pigmentation, thickness, and flexibility of scars.

What are the benefits of massage for scars?

Post-surgical scar massage is a valuable tool in the recovery process, helping to improve the appearance, flexibility, and functionality of scar tissue.

Incorporating scar massage into postoperative care, always under the guidance and supervision of a healthcare professional, can make a significant difference in the final outcome of the scar.

Why massage a post-surgical scar?

Massaging a scar helps to:

• Improve blood circulation: Increases blood flow to the area, which promotes the delivery of nutrients and oxygen, essential for tissue repair and regeneration.
• Prevent and break up adhesions: Adhesions are bands of scar tissue that can form between tissues or organs, causing pain and restricting movement. Massage helps prevent excessive formation and release existing adhesions.
• Increase flexibility and elasticity: Massage helps collagen fibers organize themselves more effectively, making the scar softer, flatter, and less rigid.
• Reduce pain, itching, and altered sensitivity: By mobilizing tissues and improving circulation, massage can relieve discomfort associated with scarring.
• Improve aesthetic appearance: A massaged scar tends to be less bulky, reddened, and visible in the long term.
• Promote lymphatic drainage: Helps reduce swelling and remove excess fluid from the area.

When to start massages?

Dr. Julio Puig advises his patients to wait until the surgical wound is completely closed, with no stitches or scabs, and there are no signs of infection (redness, oozing, increased local heat, severe pain).

This usually happens several weeks after surgery, but the exact timing should be indicated by the surgeon or healthcare professional following the case. In some cases, you can start by gently massaging the tissue around the scar before working directly on it.

What does scar massage involve?

There are several techniques that can be used, often in combination, depending on the characteristics of the scar and the stage of healing. Some of the most common include:

• Circular massage: Apply gentle but firm pressure with your fingertips, making small circles on and around the scar.
• Longitudinal and transverse massage: Move the skin parallel to the scar (longitudinal) and then perpendicular to it (transverse), seeking to mobilize the underlying tissues.
• Pinching and rolling: Using your thumb and index finger, gently pinch the scar and surrounding tissue, trying to lift it and roll it between your fingers. This technique is useful for releasing adhesions.
• Zigzag mobilization: Place your fingers on either side of the scar and make “Z” or “S” movements to loosen the tissue.

The pressure applied should be firm but not so strong as to cause intense pain. It is normal to feel slight discomfort or a stretching sensation.

Adjuvant products

Moisturizing and regenerating oils or creams can be used to help the fingers glide over the skin and nourish the scar. Products such as rosehip oil or specific scar gels are common options.

How often and for how long should I massage scars?

The frequency and duration of massage may vary depending on the professional’s recommendation, but it is generally suggested to do it 1 to 3 times a day, for 5 to 10 minutes each session. Consistency is key to getting good results.

What precautions should I take?

• Always consult your plastic surgeon or a specialized physical therapist before beginning to massage the scar to ensure that it is the right time and to learn the recommended techniques for your particular case.
• Do not massage open wounds, stitches, staples, or signs of infection.
• Avoid applying excessive pressure that causes significant pain or damage to the tissue.
• Protect the scar from the sun, as sun exposure can cause pigmentation and make it more visible. Use a high-spectrum sunscreen.
• You should come in for massages on a regular basis to see long-term improvements.
• If you experience increased pain, redness, or swelling after the massage, talk to Dr. Julio Puig, who will decide whether to pause or suspend the sessions.

In cases of complex, retractable, or hypertrophic/keloid scars, the intervention of a physiotherapist specializing in scars is essential, as they will be able to apply more specific and complementary techniques such as advanced manual therapy, cupping, or radiofrequency.

For which plastic surgeries are scar massages particularly recommended?

Scar massage is commonly recommended for various plastic surgeries due to its benefits for the maturation and appearance of scars, as well as for overall tissue recovery.

Although the specific indication and timing should always be guided by plastic surgeon Dr. Julio Puig, there are certain procedures where this type of massage is particularly recommended:

Massage for abdominoplasty scars

In abdominoplasty, excess skin and fat are removed from the abdomen and the muscles are tightened, resulting in an extensive scar. Massage helps to:

• Prevent and treat adhesions between the skin and deep muscle tissues.
• Improve flexibility and flatten the scar.
• Reduce swelling and improve lymphatic drainage in the abdominal area.

Scar massage for breast surgery (augmentation, reduction, and mastopexy)

Breast surgery involves scars around the areola, vertical scars, or scars in the submammary fold.

In these cases, massage helps to:

• Soften and flatten scars, which can tend to thicken.
• Improve the elasticity of the skin and surrounding tissues.
• In the case of implants, some surgeons may recommend specific massages to help the capsule around the implant form correctly (although recommendations vary and the surgeon’s instructions should be followed strictly).

Massage for blepharoplasty scars (eyelid surgery)

Although the incisions in upper, lower, or complete blepharoplasty are usually fine and inconspicuous, gentle massage of the periorbital area may be beneficial for:

• Reducing edema (swelling) and bruising.
• Improving local circulation.
• Helping to soften fine scars in the natural creases of the eyelids.

Massage after facelift and neck lift

In facial rejuvenation procedures such as facelift or minilift, or neck lift involving skin extensions and tissue repositioning, scars are commonly located around the ears and along the hairline.

Massage in these areas helps to:

• Improve drainage and reduce facial and neck swelling.
• Soften and loosen scars to make them less noticeable.
• Release possible tension in facial tissues.

Massage after liposuction and liposculpture

Although liposuction incisions are small, post-operative massage, often in the form of manual lymphatic drainage and deep tissue massage, is essential to:

• Reduce the swelling and extensive bruising characteristic of these procedures.
• Prevent fibrosis and body contour irregularities caused by internal scarring.
• Promote the skin’s readaptation to the new contour.

In general, in any plastic surgery where there is an incision in the skin, scar massage can be a useful tool to optimize the healing process and improve the aesthetic and functional outcome of the scar, as long as it is performed at the right time and with the correct techniques under professional supervision.

It is essential to follow the specific instructions of your plastic surgeon, as each patient and each surgery are unique.

Scar massage is an important part of post-surgical scar management, promoting better healing, functionality, and appearance. However, you must follow medical instructions and be patient, as the scar maturation process takes time.

You want the best aesthetic results for your scar

Post-operative recovery should not be a period of uncertainty, pain, or fear about the final appearance of the surgery and your scar. With scar massage, not only will you feel better, but you will also see your scar gradually fade, achieving a more aesthetic result.

It’s not just a massage. It’s an investment in better results, faster post-operative recovery, better health, and greater confidence.

Schedule your free evaluation and discover how we can help you

Do you want a faster, safer, and more professional recovery?

📅 Schedule a free evaluation with our post-surgical scar massage specialists today.

👩‍⚕️ We will help you design a personalized plan that complements your surgical procedures with the best post-operative care.

Other types of post surgical massage

Lymphatic drainage massage – Fibrosis after lipo massage – Circulation massage – Scar tissue massage– Anti-cellulite massage – Relaxing massage – Anti wrinkle facial massage