Dr. Mariane has been familiar with plastic surgery since childhood, as her mother was a surgical instrument technician at the Ivo Pitanguy clinic. In 1994, Dr. Enzo Rivera invited her to assist his postoperative patients. At that time, with only training in massage therapy and under his guidance, she treated patients using massage techniques.
Caring for patients and witnessing their daily improvements was highly rewarding. However, fibrosis remained a persistent issue. This led her to seek a deeper understanding of these common yet challenging complications. The following year, she enrolled in a physiotherapy degree program and began searching for specific treatments to address the complications she found difficult to resolve. Throughout her studies, she applied various physiotherapeutic techniques to patients as she learned new methods and tools. Simultaneously, she collaborated with multiple plastic surgeons, including Dr. Bárbara Machado, who was one of her greatest supporters in research and treatment development—someone she continues to work with today.
During her studies, she met Professor Vera Borsato, who, with her expertise in manual therapies, guided her on how to study and apply techniques to patients in the healing phase. By the time Dr. Mariane graduated as a physiotherapist, she had already established an effective treatment for the feared fibroses. Through clinical practice, she adapted her techniques to the needs of patients, who often exhibited similar characteristics, such as fibrosis, adhesions, and edema. This led to the creation of the manual treatment strategy developed by Dr. Mariane, which later became the foundation for Functional Tissue Release (LTF®), encapsulating her entire treatment concept.
Dr. Mariane completed her physiotherapy degree in 2000, already highly experienced in treating these patients and deeply passionate about her work. She continued her studies, pursuing a postgraduate specialization in Dermatofunctional Physiotherapy in 2001, which eventually led her to teaching.
In 2004, she began her scientific career as an intern at the Tissue Repair Laboratory at UERJ. By 2006, she had enrolled in a master’s program in Human and Experimental Biology, under the supervision of Professor Andréa Monte Alto Costa. This opportunity introduced her to the world of research, significantly enhancing her expertise.
As she delved deeper into wound healing and mechanical tension research, she had to modify her treatment strategy again, considering that structural changes in healing tissues are influenced by the type of treatment applied. During her master’s program, she acquired a solid experimental scientific foundation that shaped her future work.
By 2015, feeling stagnant and unfulfilled with only an experimental scientific background, she decided to immerse herself in orthopedic manual physiotherapy training. This allowed her to gain a deeper understanding of neuromyoarticular dysfunctions resulting from tissue damage caused by various surgeries, including obstetric, orthognathic, orthopedic, oncological, and plastic surgeries. This knowledge led to a complete restructuring of her previous therapeutic strategies, ultimately resulting in the development of Physiotherapy for Scar Tissues.
With the mission of sharing this knowledge with as many physiotherapists as possible, she founded the Instituto Mariane Altomare in 2019. Today, the institute has a faculty of eight professors and operates in major capitals across Brazil and Europe.
Dr. Mariane is a passionate and fulfilled professional. One of her main goals is to dispel the misconception that fibrosis has no treatment—it does, and it is quite simple once the physiological mechanisms behind its formation are understood.
She advocates for evidence-based, updated physiotherapy and is dedicated to spreading awareness of specialized physiotherapy among plastic surgeons and patients. She envisions a future where everyone can benefit from the proposed physiotherapeutic treatment.
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