Short answer: yes, at 35 days post-LSCS you can generally start using silicone gel sheets, provided the incision is fully closed with no scabs, discharge, or open areas - which looks to be the case in your photo (the scar reads as a clean, closed, linear vertical incision with no signs of gaping, active discharge, or infection; the pink/reddish color is normal for this healing stage and typically fades over the following months).

One caveat: I'm assessing the photo generally, not diagnosing you individually. Since this is a C-section incision with layers beneath the skin still healing at 5 weeks, it's reasonable to get a quick in-person or telehealth check with your obstetrician before starting, particularly to rule out any subtle separation or early hernia/seroma at the incision site that wouldn't be obvious from a single photo.

A recent (2025) systematic review in the Emergency Medicine Journal (PMID 40523697) on facial laceration silicone use found similarly modest but favorable results, and a 2021-2023 batch of Cochrane reviews (PMID 34564840, 36594476) I cited above are the most current high-quality evidence — nothing in the recent literature contradicts standard advice to start silicone sheeting once a surgical wound is closed.

The C-section incision cuts through skin, fascia, and often adheres to the layers beneath (rectus sheath, peritoneum). As these layers heal, scar tissue can form adhesions - sticky bands where tissue that should glide freely gets tethered together. When the deeper layers get pulled down or stuck, it creates that shelf-like pouch or overhang above the scar, distinct from just skin-level scarring. This is a tissue-mobility issue, not simply a discoloration/thickness issue, which is why silicone sheeting (mainly a surface/dermal treatment) helps the look of the line itself but doesn't address deeper adhesion-related bulging as directly.

One caveat: robust RCT evidence specific to "C-section shelf" reduction with massage is still limited - most support comes from adjacent literature (general scar massage, cesarean manual therapy studies, and adhesion-stiffness correlations) plus consistent clinical/physical-therapy practice, rather than large dedicated trials proving it eliminates the shelf. It's a low-risk, reasonable practice to try, but expectations should be realistic - it improves tissue mobility, softness, and comfort more reliably than it fully "erases" a shelf caused by fascial-level scarring or by abdominal skin/fat changes from pregnancy itself.

Based on what's driving a "C-section shelf" (scar tethering/adhesions + sometimes skin laxity, diastasis recti, and local fat), the interventions that help most, roughly in order of effectiveness and how accessible they are:

1. Scar mobilization / massage - the single most impactful non-surgical step This directly targets the root cause in most people: the scar getting stuck ("tethered") to the fascia and tissue layers beneath it. Manual therapy studies on cesarean scars show measurable changes in scar tissue structure and stiffness with mobilization (Olszewska et al. 2024, PMID 37665082; Seven et al., elastography study, PMID 33020987 linking scar stiffness to adhesions). Daily massage - vertical/horizontal/circular strokes plus "skin rolling" - loosens these adhesions so the tissue above the scar can move and lie flat again, rather than staying pulled down into a shelf.

2. Pelvic floor and core physical therapy - addresses a second major contributor A lot of "shelf" appearance isn't the scar alone but co-occurring diastasis recti (separated abdominal muscles) and a weakened core/pelvic floor from pregnancy. Postpartum PT that retrains the deep core (transverse abdominis) and closes the diastasis gap changes the shape of the lower abdomen independent of scar work. This is why several sources note that diet and general exercise alone often fail - they don't address either the scar tethering or the diastasis, which are structural, not just fat-related.

3. Time and continued combined care Scar remodeling continues for 12-18 months. Combining massage with silicone sheeting/gel (for the skin-level appearance, thickness, redness) gives the best overall combined result and is what you're already doing appropriately at your stage.

4. Weight management - a minor, not primary, factor Helpful only if there's a genuine excess-fat component sitting above the scar, but multiple clinical sources emphasize that lean, fit women can still have a prominent shelf because it's structural (scar/fascia/muscle), not fat - so this is the least reliable lever on its own.

5. Surgical options - most effective for persistent/severe cases, but invasive When shelf is due to significant skin laxity, marked diastasis, or dense scar tethering that doesn't respond to months of conservative care, definitive options include:

These are generally considered after conservative measures have been tried for several months to a year, and usually once someone is done having children.

Bottom line: for where you are now (5 weeks post-LSCS), scar massage combined with pelvic floor/core physical therapy is what will move the needle most - start massage once your incision is fully closed (as it appears to be), add silicone sheeting for the skin surface, and get a postnatal PT assessment around your 6-week check to evaluate for diastasis recti, since treating that alongside the scar gives the best combined result. Surgery is a later option only if the shelf persists despite months of consistent conservative treatment.