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Healing from Your C-Section Scars

Giving birth to your beautiful little miracles is quite the journey, an experience filled with the excitement of parenthood. To some mums, it may happen through a Caesarean section, whether as a preference or a necessary intervention. Precious in essence, it leaves behind a physical reminder of the journey—C-section scars. Recovering from these scars encompasses physical and emotional healing; it can be confusing and challenging all at the same time. At Embrace, we’re here to help ease this process and help you through your journey as your c-section scar heals.

Since there is so much information, we’re discussing this through three parts:

What is a c-section?

The c-section incision goes through several layers of abdomen, represented here by a kiwi fruit. The C-section scar will take time to heal as each layer knits back together.

A c-section, aka Caesarean section, is a procedure involving an incision to the lower abdominal region under general anaesthetic or spinal block to birth your baby. The c-section incision is made through seven layers of your abdomen which are the skin, fatty tissues, rectus or abdominal sheath, two layers of peritoneum, uterus, and amniotic sac.

How long will it take for my c-section scar to heal?

Postnatal healing typically centres around the six-week mark. Even when c-section scars may look improved, healing continues for up to a year in different stages.

  1. Haemostasis Phase: Platelets quickly clot to stop bleeding during surgery.
  2. Inflammation Stage: This phase controls bleeding, prevents infection, and results in swelling, redness, and discomfort.
  3. Proliferation Phase: Days two to five post-surgery involve collagen layer formation, creating a disorganised structure for wound contraction. New blood vessels are constructed for healthy oxygen and nutrient supply.
  4. Remodelling Phase: From days five to fifteen, collagen fibres realign for optimal tensile strength and flexibility.

Abdominal muscles typically regain only around 50% of original tensile strength at six weeks, reaching 73-93% by six to seven months (Ceydeli et al., 2005). This information helps with the timing and types of exercises recommended for your recovery.

WHEN CAN I START C-SECTION SCAR MASSAGE?

A medical professional should give you the go signal. Start massaging when the scar is dry, free of scabs, and not bleeding or oozing, typically around four to six weeks post-birth. Individual variations may apply, so pay attention to your body’s signals. If provided, use a silicon-based cream or sheet recommended by your doctor for scar massage.

 

Consult your doctor if you observe any of these signs with your scar:

A red, painful c-section scar is cause for concern. Contact your doctor for if your scar shows any worrying signs of infection.● Redness
● Heat
● Bruised
● Bleeding
● Discharge (fluid)
● Swelling
● Fever
● Foul odour

MY C-SECTION SCAR IS STILL PAINFUL, WHAT CAN I DO?

Scar sensitivity can be influenced by factors like the surgeon’s technique, sleep, genetics, nutrition, and hydration. Here are some ways you can help improve it.

  • Wellness Recovery: Quit smoking, manage diabetes effectively, limit alcohol intake, and optimise nutrition to support scar healing. Scars may also hold emotional memories, particularly after a traumatic birth. Focus on both physical and emotional recovery.
  • Scar Care: About 6% of women still struggle with scar pain after 12 months, with 2% experiencing severe pain (Jin et al 2016 and Nikolajsen et al 2004). If this is you, gently stroke the sensitive area with a clean brush. Nerves regenerate at approximately one mm per month. Consult with your women’s health physiotherapist for additional strategies to desensitise the scar.

Hydration: Keep the scar and surrounding tissue hydrated using recommended creams like silicon, Vitamin A or D, or rose hip for optimal skin quality and reduced sensitivity.

What is a keloid scar?

A keloid scar occurs when scar tissue extends beyond the original wound boundaries, typically due to an overproduction of collagen during the healing process. This excess collagen forms scar tissue lumps around the incision, potentially limiting mobility.

Women with darker pigmented skin are more likely to develop a keloid scar, followed by people of Hispanic and Asian backgrounds. Keloids are more common in persons younger than 30 years, and in patients with elevated hormone levels such as during puberty or pregnancy (Juckett et al 2009, and Brissett et al 2001).

A c-section scar massage may not be effective for keloids. Consult your doctor for a dermatologist referral, possible treatment options include corticosteroid injections, laser therapy, and cryotherapy.

I’ve got this shelf of skin/pooch- what can I do about that?

Understanding factors such as excess skin, fat, diastasis recti, scar tissue or loss of muscle tone guides the approach for treatment, which may include targeted exercises, dietary adjustments, laser therapy, or surgical intervention.

Should I wear an abdominal binder after c-section?

SRC recovery range to help you recover after your c-section

Consider wearing an abdominal binder after a c-section, as it provides support for the healing wound, aids in pain management, and facilitates daily activities (Tussey et al., 2019). Tubi-grip or SRC recovery shorts or pants are suitable compression garment alternatives. Visit our clinic for proper sizing and to try the product!

If you have questions about Jamu Jamu Binding or want to learn more about abdominal binding in the postnatal period read our other blog click here.

How much can I carry after a c-section?

Use your baby’s weight as a reference when lifting. If you have other children, ask them to climb up to minimise the strain on your scar, pelvic floor, and back.

When should I see a women’s health physiotherapist?

Six weeks ideally, and read about it here!

Hey Mum, this blog post is intended as general advice. You only get one chance to do it right, know better, and do better. Let’s do it together!

If you feel like you could benefit from specialised guidance and treatment for your c-section recovery, we are here to help. Please call or WhatsApp us at 9780 7274, or get in touch with us at help@embracephysio.sg!

Feel free to look through our website, where you can learn about other women’s health conditions we treat. This is a safe space where we can discuss how we can help you with physiotherapy.

Note: While I am a physiotherapist, I am not your personal physiotherapist. The contents of this website are for informational purposes only and are not intended to serve as individual medical advice.

References:

  1. Betarbet U, Blalock TW. Keloids: A Review of Etiology, Prevention, and Treatment. J Clin Aesthet Dermatol. 2020;13(2):33-43
  2. Brissett AE, Sherris DA. Scar contractures, hypertrophic scars, and keloids. Facial Plast Surg. 2001;17(4):263–272.
  3. Ceydeli A, Rucinski J, Wise L. Finding the best abdominal closure: an evidence-based review of the literature. Curr Surg. 2005;62(2):220-225.
  4. Jin J, Peng L, Chen Q, Zhang D, Ren L, Qin P, Min S. Prevalence and risk factors for chronic pain following cesarean section: a prospective study. BMC Anesthesiol. 2016 Oct 18;16(1):99.
  5. Juckett G, Hartman-Adams H. Management of Keloids and Hypertrophic Scars Am Fam Physician. 2009 Aug 1;80(3):253-260.
  6. Nikolajsen L, Sørensen HC, Jensen TS, Kehlet H. Chronic pain following Caesarean section. Acta Anaesthesiol Scand. 2004 Jan;48(1):111-6.
  7. Shin, TM and Bordeaux, JS. The role of massage in scar management: a literature review. Dermatol Surg, 2012. 38: 414–423.
  8. Tussey C, Kelly LA, Oja KJ, Bay RC, Makarova N. Reducing Discomfort After Cesarean Birth Using Abdominal Binders. MCN Am J Matern Child Nurs. 2019 Nov/Dec;44(6):310-316. doi: 10.1097/NMC.0000000000000571. PMID: 31490194.
  9. https://www.embracephysio.sg/what-you-need-to-know-about-diastasis-recti-in-women/
  10. https://www.embracephysio.sg/what-is-a-perineal-tear-and-episiotomy/
  11. https://www.embracephysio.sg/what-is-a-womans-pelvic-floor/
5 Star Google Reviews
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It is so amazing to have this wonderful clinic in the East! (no need to go traipsing into the hospital areas/zones to access amazing care). I started seeing Preet at Embrace during the second trimester of my pregnancy. She's a really gifted physio - the kind who provides great treatment as well as in-depth information, underscored by excellent communication skills. She really helped to relieve the pain I was experiencing. I have since received post-natal care at Embrace and have also started going to their weekly pilates classes, which are targeted for women. It makes all the difference to have a pilates teacher who's already aware of all your physio requirements! 5 stars!

Kirrilee Hughes Avatar Kirrilee Hughes
November 8, 2021

I had a wonderful experience with Brenda throughout my post partum recovery. She is very friendly and experienced and it definitely shows as she is able to make me feel at ease and comfortable as she navigates me through the exercises and steps to get me back to where I want to be. Appreciate the help and for making it easy especially with motherhood alr being a challenge. Thanks 🙂

Liying Ho Avatar Liying Ho
March 31, 2022

Highly recommend Embrace for women's PT. I saw Preet after the birth of my son and she took very good care of me, helping me to build my strength back. All the staff are lovely, I had a great experience.

Katherine Lobo Avatar Katherine Lobo
July 13, 2022

Embrace life. Embrace Physiotherapy.

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