02/06/2025
This work deserves greater awareness and it would be wonderful if it became a standard part of the recovery process
I have worked with a wide range of breast cancer scars, from small lumpectomies to full mastectomies, supporting individuals both during treatment and long after it has ended. My experience includes treating reconstructed breasts using both DIEP flaps and implants, including complications such as capsular contracture. In some cases, the DIEP flap donor site scar has proven more problematic than the breast area itself, requiring focused care. There is always more that can be done beyond the medical setting. Being discharged doesn’t mean the journey is over. There is always hope, and always a next step toward healing.
Imagine being left with a scar after mastectomy and radiotherapy that is like this and being told “nothing more can be done”. While this is not representative of most mastectomy scars, some individuals are left with deeply adhered (stuck) scars after cancer surgery and radiotherapy. The tissue becomes so damaged that further surgery may create more problems than it solves.
This type of scar will respond to Restore Scar Therapy massage techniques, which should soften and bring more mobility into the area. As the tissue moves more, the colour should improve and the tightness and folds will also soften and reduce. It will take many months of regular treatment across the next year or more to achieve this. It won’t ever be back to “normal” but it should be significantly better.
If we were able to see the client sooner, before the area became fully mature following surgery, it’s likely this situation could have been avoided to some extent.
Once the scar is fully mature the blood supply to the superficial tissues reduces. Folds, puckering and adhered scar tissue then further reduces blood and lymph supply (which is required for healthy skin and fascia). As the area becomes more stiff, tightness (and possibly pain) will make normal movement reduced. As this person stops moving the area to avoid pain, so the situation will further be compounded, with more stiffness and tightness in the surrounding tissue occurring.
In order to promote recovery we must reverse this spiral. Gently encouraging tissue mobility (slide and glide, one milimeter at a time). Massage movements that are stimulating blood and lymph to the area. This in turn will allow us to slowly increase movement in the arm and an opening and stretching of the chest. The spiral can then start to move in the opposite direction towards recovery. ❤️🩹
By ensuring education is delivered and shared to both therapists and health professionals such as surgeons, radiotherapists and clinical nurse specialists on the benefits of scar massage is essential for change. Scar massage is a simple, yet effective - and importantly - highly accessible modality.
Together if we share this information and these skills, we can improve patient outcomes after cancer surgery and radiotherapy.
