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The Healing Touch: Physical Therapy and Scar Care After a Mastectomy

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Healing begins not only in the body, but also in the soul

A mastectomy is not just a surgical procedure—it is a life-changing event that affects a woman both physically and emotionally. Although the scar remains a visible sign of a past battle with cancer, it can also become a place of healing. It is precisely through mindful touch, breath, and gentle care that a woman can reconnect with her body.

Why Not Be Afraid of Scars?

For many women, the scar left after a mastectomy is a symbol of trauma. Many do not want to see it or even touch it. But experts agree: consciously engaging with the scar is the first step toward healing.

“Our minds tend to push the scar to the back of our minds. But it is precisely by engaging with it that healing begins,” says physical therapist Katarína Hanuliaková.

How do you care for a mastectomy scar?

Daily Massage

We only refer to it as a scar once the surgical wound has healed, the stitches have been absorbed or removed, and the scabs have fallen off. The tissues must grow together for us to consider it a high-quality scar. This process takes several weeks. On average, 6–8 weeks after surgery.

We can promote the healing of a surgical wound through proper care, ventilation, breathing, lymphatic taping, gentle touch, and positioning.We don’t start the massage itself until the scar has formed!

Massage helps improve blood circulation, reduces scar tissue formation, and restores elasticity to the tissues. You can massage a scar basically anytime—for example, after an evening shower, when your skin is warm and soft. However, it’s best to devote the first moments of each day to yourself and your body—in other words, to take care of yourself first thing in the morning.

Recommended procedure:

  1. Consciously breathe into your chest area.

  2. Gently stroke your breast and explore how the touch itself feels to you.

  3. Gently run your fingers over the scar.

Frequency of massages:

5–10 minutes a day. Even a short ritual can have a big impact on healing.

What causes adhesions under a scar?

If the scar is left untreated, tissue adhesions may form, which slow down airflow, create a barrier, limit lung capacity, and cause tightness and pain.

Other common problems associated with adhesions include:

  • restricted movement of the hand or arm,

  • pain when breathing,

  • a feeling of tension or the presence of a “foreign object.”

That is another reason why it is important to massage the scar regularly and monitor how it changes.

Respiratory Physical Therapy—The Forgotten Power of Breathing

After chest surgery, a woman’s breathing in that area is naturally restricted. Breathing becomes more superficial and shallow, leading to a lack of oxygen in the body and subsequent fatigue, tension, and reduced organ function. Once the wound has healed, it is very important to restore respiratory capacity and support the development of the chest and intercostal spaces.

A simple breathing exercise:

  • Place your hands on your ribs.

  • Take a deep breath through your nose, filling the sides of your chest,

  • Exhale slowly through your mouth.

  • Repeat for 3–5 minutes every day.



“Breath is a bridge between the body and the mind. When we are consciously aware of it, we heal ourselves from within,” adds Katarína Hanuliaková, an intimate physical therapist.

Interview: Katarína Hanuliaková on the Power of Touch

What is the most common reaction women have to a mastectomy scar?

Most women don’t want to see or touch their scar. It’s a form of psychological defense. But only when she consciously confronts the scar can she accept it as a part of herself. Every touch of the scar is an act of healing.

What is the most important first step?

A gentle touch. Place your palm on the scar, nothing more. Just breathe and be present with that spot.

How often should you get a massage?

Every day. Even if it’s just 5 minutes. It’s not about performance, but about giving loving attention to yourself and to the place that needs to heal.

Why include breathing exercises as well?

Because breathing affects the nervous system, it relieves tension and helps a woman reconnect with her body. At the same time, breathing supports the functioning of all the body’s organs.

What is your message to women?

Your body is strong. That scar is proof that you survived—that you fought for your life. You deserve compassionate care and respect.

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The body does not need to be fixed. It needs to be understood.

I am a woman, wife, mother and physiotherapist. Over the years of practice, I have realised that health does not come only from eliminating symptoms or solving a specific problem. Real change comes when a person begins to better understand themselves, their body, and the way they live their life.

It was this idea that led me to create the space you know today as ToBe – a place where different areas of expertise, perspectives, and approaches to health are interconnected. A place that does not see a person only through a diagnosis or individual symptoms, but as a unique whole.

My professional journey began in physiotherapy and the musculoskeletal system. Over time, clients and their stories gradually led me deeper – from working with the body through the pelvic floor to understanding the meaning of emotions, the psyche, and the functioning of the nervous system. Today, I see the body as the bearer of a person’s story, and therapy as a space where we can get to know that story, understand it, and support its natural process of change.

How I work

Years of practice have taught me to slow down. To listen more. To place less emphasis on performance, results, or quick change.

In therapy, I strive to create a safe space where clients can become more aware of their bodies, their needs, and the connections between what they are experiencing and what is happening on a physical level. I don’t focus only on symptoms; I also look for their possible causes and the context in which they arise.

Over the years, I have become increasingly aware of how closely the body, mind, and nervous system are connected. This is why I naturally integrate a psychosomatic perspective and the principles of nervous system regulation into my work – gently, clearly, and always with respect for where each client is in their own process.

I believe the body has a remarkable capacity for healing and renewal. Sometimes it doesn’t need more pressure — it needs understanding, a sense of safety, and the right conditions to begin functioning in a different way.

What I can help you with

In my practice, I specialise mainly in:

  • urogynecological physiotherapy
  • pelvic floor dysfunction
  • incontinence
  • painful conditions after childbirth
  • preparation for childbirth and postpartum recovery
  • painful menstruation
  • pain during sexual intercourse
  • functional disorders of the musculoskeletal system
  • chronic pain without an organic cause
  • unintegrated scars
  • psychosomatic connections of health problems
  • regulation of the nervous system

Methods and approaches I use

In my work, I connect physiotherapy with knowledge from psychosomatics, work with the nervous system, and a holistic therapeutic approach. I mainly use:

  • urogynecological physiotherapy
  • pelvic floor therapy
  • diagnosis and therapy of functional disorders of the musculoskeletal system
  • visceral manipulation
  • osteopathic principles
  • craniosacral therapy
  • psychosomatic approach in physiotherapy
  • principles of nervous system regulation
  • knowledge from Somatic Experiencing® training

In therapy, I combine professional knowledge with a sensitive perception of the person and their story. My goal is not only to relieve the problem, but to support the client in better understanding themselves and their body.

ToBe – the concept

ToBe grew naturally out of the original IntimFyzio centre. Over time, I increasingly felt the need to bring different areas of expertise together and create a place where a person does not have to be divided into separate parts.

Today, ToBe is a multidisciplinary space where physiotherapy, psychology, psychotherapy, women’s health, traditional Chinese medicine, work with the nervous system, and other approaches come together – united by a common idea: to see a person in their entirety and create the conditions for health, growth, and a deeper connection with oneself.

Education and professional development

I studied physiotherapy at the Faculty of Medicine of Comenius University in Bratislava, and completed my master’s degree at the University of Brighton in the United Kingdom.

I have completed a specialisation in functional and structural disorders of the musculoskeletal system at the Slovak Medical University in Bratislava. I hold a licence for independent medical practice and am a member of the Slovak Chamber of Physiotherapists.

Training that has significantly shaped my therapeutic approach

  • Somatic Experiencing® (currently in training, Lilian Troost)
  • Psychosomatic approach in physiotherapy (CKP Edu, Prague)
  • Visceral manipulation and osteopathic approach (Inge Schuermans, MSc)
  • Birth trauma in physiotherapy and self-regulation tools in client practice (Mgr. Radka Tomášková)
  • Holistic approach to scar and pelvic floor therapy (PhDr. Michaela Prokešová, PhD.)
  • Traditional care for women and mothers (Angelina Miranda Martinez)
  • Osteopathic approach in pregnancy and gynaecological dysfunctions (Inge Schuermans, Jory Paul)
  • Ludmila Mojžišová method (Mgr. Jana Jedličková)
  • Physiotherapy of pelvic floor dysfunction and urinary incontinence (Prof. Magdaléna Hágovská, Mgr. Zuzana Woleková)
  • Craniosacral therapy (Mgr. Helena Toušková, Upledger Institute)
  • Certified DNS Therapist Diploma (Prof. Pavel Kolář)
  • Diagnosis and Therapy of Functional Disorders of the Musculoskeletal System (Eva Janíková)
  • Stott Pilates (Jitka Kadish)

I believe health is not a goal to be achieved. It is a relationship we build with ourselves, our bodies, and our lives – and it is a journey I love to accompany my clients on.