C-sections often have bad or poor scars that can easily be treated with cosmetic surgery. This educational writing will review the causes of poor scars after a C-section. It will also review treatment options, and the best way to treat the scar. The three main options include a scar revision, a mini tummy tuck, or a full tummy tuck cosmetic operation. Women can have operative procedures that can give them a flat, smooth, and pretty scar and improved contour to the abdominal area. An abdominoplasty is not the only choice. This question was raised by a patient from Media, PA with a C-section scar that was painful and unsightly.
Why is my C-section scar bad?
First, it is important to understand what a “good” scar looks like. All scars fade, but they don’t go away completely. A good scar will be flat, thin, and have similar color to the surrounding skin. The scar should not be painful, itchy, or irritated. Next, it is important to understand the characteristics of a “bad” scar. Bad or poor scars are depressed or elevated and often hard. They might be pigmented, colored, or itchy and painful. They can also have fat accumulate above the scar giving a “lip” or a ” ledge.” These characteristics are unfortunately much too common after C-sections.
During a C-section operation, the incision is made in the skin, muscle layer, and the uterus in the same plane or location. This allows quick and easy removal of the baby. This is the most important part of the operation- the safety of the baby. However, the different layers are cut in the same plane, and then they all fuse or heal together. This leads to the skin getting “stuck” or fused to the deeper muscle layer. This results in the scar being puckered and unattractive. It’s not the Ob-Gyn doctor doing a poor job. It’s the technique that helps get the baby out quickly. The same technique leads to poor scars much too frequently.
What are my options to fix the problem scar?
There are three main choices to repair and improve this area. The first is a scar revision. The second is a mini tummy tuck. And the third is a classic or full tummy tuck. It is important to understand choices. A woman needs to decide if she is interested in improving the rest of her stomach at the same time. Is it just the scar that’s the concern? Or, do we want more improvement and a flatter stomach overall?
1- Scar Revision:
C-section scar revisions are procedures directed mainly at improving the scar itself. The scar is excised or removed. It is then repaired in multiple layers with tiny plastic surgery stitches. The result is usually a flatter, nicer, and thinner scar, without the depression or ledge. I usually remove “extra skin” around the scar to really improve the lower abdominal area. By doing this, I can give the patient a better result. This extra skin removal leads to a result that is almost, but not quite as flat as, a mini tummy tuck result. No muscles are tightened with this approach, but it usually really improves the problem. The operation can be done with local anesthesia. Getting back to work and exercise is quick. Recovery is short.
2- Mini Tummy Tuck:
While we are fixing the scar, can we get more surgery to make the whole stomach and abdominal area look better? Yes, this is a great time to consider this. Most woman who have had a C-section have muscle weakness from having babies. The stomach probably also has loose skin, stretch marks, and weak muscles. The mini tummy tuck adds liposuction and muscle tightening for the goal of a much flatter and thinner stomach. The muscles are repaired to a more tighter and youthful position. I repair them with what I call the “California Corset.” This muscle repair, I believe, is extra tight and gives a more attractive and tight stomach. Please click here to read more about my “California Corset” repair.
3- Classic or Full Tummy Tuck:
A tummy tuck or abdominoplasty is often the best option to improve the stomach area after babies. Why? It is the operation that removes the most skin and loose tissue and gives the flattest and best results. It’s the option that is the biggest or largest procedure, but it is also the operation that some consider the “gold standard” or best. Liposuction and liposculpturing are done to contour the surrounding area and sides. Muscle tightening with the “California Corset” is done to repair and improve the muscles. The “Pain Buster” is used to dramatically improve the recovery from the operation. Patients having this operation will need to allow for appropriate time to recover. For those who are interested in more information on the “Pain-Buster” please click here. Patients are rarely disappointed with the classic or full tummy tuck results, as the recovery is well worth the extra flat stomach.
Patients interested in their C-section scar and options for treatment should come in for a consultation. I will thoroughly review and examine their particular case. We can determine what will be best for you.