Many women who have had children by C-section have difficulty with the C-section scar when they no longer have children. Although a more easily concealed transverse incision is most commonly used, many patients have had a vertical incision that is highly visible in a bikini.
Many patients complain of the following problems, including:
• Bread-Pain is more common early after surgery. The incision line may become raised, red, itchy, and painful. These signs usually start around 6 weeks after delivery.
• tied or tight scar-In the longer term, the incision site may become tight and depressed as the tissues adhere to the underlying muscular fascia of the abdominal wall.
• A depression in the skin.-the incision line may become depressed and if the normal fat around the area has been damaged, a deep indentation may form in the incision area that is visible on clothing.
• A pouch or fold of skin in the lower abdomen-Many patients complain that they have a bag or a loose fold of skin in the lower abdomen after C-section. This is a fold of skin that forms over the transverse incision and is caused by wound contraction. It is called a “trapdoor” deformity and many patients complain that the pouch or fold of the belly can be seen through clothing.
Options to improve cesarean scars
• steroid injection – A red, raised, painful incision can often be treated with injections of a corticosteroid solution. Usually 2-3 injections 6 weeks apart are required to reduce the size and redness of the incision line. In the long term, these injections can cause problems such as fat atrophy: the scar is depressed. In addition, the growth of visible blood vessels in the skin may occur. For this reason we are now using Laser Treatments or IPL Treatments.
• IPL-Intense Pulsed Light- IPL is a light treatment similar to a laser. IPL is an effective treatment for a red incision. The earlier treatment is started, the more effective IPL will be. We can treat red incisions as early as 3-4 weeks and typically 3-4 treatments 6 weeks apart are required.
• Non-ablative fractional laser 1540– The 1540 non-ablative fractionated erbium laser is effective in smoothing raised or bulging C-section scars. This is a very new modern treatment that we use frequently. Usually 3-4 sessions 6 weeks apart are required.
• Surgical Revision-Simple excision of the old incision line with careful plastic surgical closure can be very effective for many patients.
• Mini tummy tuck or bikini tummy tuck-Many patients have loose excess skin in the lower abdomen after pregnancy that they cannot tighten no matter how much exercise they do or how long they diet. Patients who have C-section scars also often complain of a lump or pouch in the lower abdomen that is very distressing, shows through clothing, and does not go away with exercise and massage. For these patients, a mini tummy tuck or bikini tummy tuck has the benefit of tightening the tummy and correcting the pouch or bulge.
Surgical revision with laser-assisted liposuction– Depressed vertical cesarean section scars are often attached to the underlying muscle fascia and the surrounding fat has been damaged. In these cases, a simple excision and closure causes the area to become depressed again after revision surgery. One solution is to excise the depressed area and use laser-assisted liposuction to reduce excess fat on both sides of the C-section scar and break down attached tissue before closing the wound.
If you’re considering treatment for your C-section scar, be sure to discuss it with your obstetrician. If you plan to have surgery, see a plastic surgeon certified by the American Board of Plastic Surgery.
Click here to see before and after photos of C-section scar correction.
