Can a Tummy Tuck Be Carried out After Four C-sections?

I have had four c-sections but would like a tummy tuck. Are there any reasons why this would not be carried out after four c-sections?

Doctor Answers 21

Tummy Tuck After C-Sections

In my Raleigh, North Carolina Plastic Surgery Practice the majority of the patients I see for tummy tucks are moms. Many women, after one or more pregnancies, will have changes in both the abdominal soft tissues (skin and fat) and the abdominal wall. This usually consists of loose, flaccid skin with (but sometimes without) stretchmarks, and outward bulging of the abdominal wall, especially below the belly button. These changes occur in response to both mechanical expansion of the abdomen by the growing baby and to pregnancy hormones that circulate in high levels only during gestation.
For most patients with these post-pregnancy changes, no amount of diet or exercise will significantly improve the abdominal appearance. Most of these patients require a full tummy tuck, as described above. A full tummy tuck involves removal of most or all of the skin and fat between the pubic area and the existing belly button, tightening of the rectus abdominis ('6-pack') muscles from the bottom of the sternum to the pubic bone, and creation of a new belly button. Some abdominal and hip liposuction is usually performed as well.
A few patients have severe post-pregnancy skin and soft tissue excess that cannot be adequately corrected by means of a horizontal, suprapubic incision alone. In select patients, a vertical midline incision can be added to allow removal of skin excess in a horizontal as well as vertical direction. A great advantage of adding this incision is the ability to draw the waist inward as the tummy tuck is closed. This procedure is sometimes referred to as an 'anchor' or 'inverted-T abdominoplasty', as the resulting scar has that configuration. The technique is performed for patients in whom the resulting improvement in the overall abdominal profile outweighs the 'downside' of a midline surgical scar.
The nature of the tummy tuck surgery that will best suit each patient is determined during the consultation and is based on the physical examination. For all patients, I draw the proposed incisions on their body with a skin marker (it washes off easily) so that it is clear what the nature of the resulting surgical scars will be. I also outline liposuction areas if that is part of the surgical plan.
Michael Law MD
Board-Certified Plastic Surgeon
Raleigh, North Carolina

Raleigh-Durham Plastic Surgeon
4.5 out of 5 stars 66 reviews

If you are close to your ideal weight, seriously consider a tummy tuck.

Your previous C-sections should not pose any significant problems with a tummy tuck. The previous C-section scar, if it is horizontal will be removed. And, if you have a vertical scar, in all likelihood this will be removed as well.

The tummy tuck is truly designed to correct the changes that pregnancies have had on the abdominal wall, whether you not you have had your children by C-section. The components of the operation: repair of muscle separation, thinning out the fat layer, and removal of excess skin, are the same. Because of how this operation can change the appearance of the abdomen in women who have had children, it remains one of my favorite operations.

The only word of caution has to do with your overall weight. The closer you are to your intended weight (and appropriate weight for you height and weight) the better the results will be. If women are significantly over weight, I will generally advise them to lose some weight prior to having this operation, in order to optimize the results. But as long as your weight is reasonable, and you are done having children, this would be a great operation to consider.

David B. Reath, MD
Knoxville Plastic Surgeon
5.0 out of 5 stars 96 reviews

Four Sure!

There is probably no better reason for a tummy tuck than four previous pregnancies, whether delivered by C-Section or vaginally.

The beauty of the procedure is that your old C-Section scar, which is possibly indented if it has been used 4 times, can most likely be repaired by the Tummy Tuck, since the incision for the tummy tuck is basically an extended lower pelvic incision. In all likelihood, there is also some laxity of the abdominal muscles, which can be repaired and tightened by the Tummy Tuck as well.

Go four it! You will be happy you did!

Athleo Louis Cambre, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 1 review

Tummy Tuck Candidate

Your previous C-sections will not impede your ability to have the surgery. Consult with 3 board certified plastic surgeons to understand your options and choose the surgeon/surgical plan that best meets your objectives/needs.

Kris M. Reddy, MD, FACS
West Palm Beach Plastic Surgeon
4.5 out of 5 stars 25 reviews

Can a Tummy Tuck Be Carried out After Four C-sections?

Thank you for the question. Based on your history and description, you will likely be a good candidate for “mommy makeover” surgery at some point.  Best to wait at least 6 months to one year prior to seeking consultation with board certified plastic surgeons. Ask to see lots of examples of their work and communicate your goals clearly as well. Make sure that you are aware that this operation is associated with a very significant physical and emotional recovery period. Generally speaking, the “ideal” patient for tummy tuck surgery is one who has completed pregnancies, is psycho socially/emotionally/financially stable, has an excellent social support system surrounding him/her, is capable of arranging enough recovery time, does not smoke and who has reached a long-term stable weight.  For most patients in your situation I also use liposuction surgery as a contouring tool, most often used in the flank areas, mid-epigastric areas and pubic areas. I hope this, and the attached link, helps.

Tummy tucks after c-sections...

Actually, many women that we perform tummy tucks on have had C-sections in the past. A tummy tuck is a great option because all of the old scarring can be removed at one time, and the tummy tuck incision that remains should be below the bikini line.  It does not matter how many c-sections you have had, as long as you are fully healed after the last one, which is usually about 8 weeks. A tummy tuck will also nicely tighten up the muscle that has been stretched after 4 children. If you want to find out more about this procedure, please be sure to seek a consultation with a board certified plastic surgeon.

Tummy Tuck after Multiple C-Sections

There is no reason that having any number of c-sections should be a contraindication to tummy tuck surgery.  Many women with c-section scars are dissatisfied with the appearance of their post-pregnancy abdomen because of the fact that the tight c-section scar can accentuate the loose, saggy skin and soft tissue that hang over the scar.  These women are delighted to find out that the tummy tuck will remove the unsatisfactory c-section scar and replace it with a well-contoured, longer tummy tuck scar surrounded by tighter, well-contoured abdominal tissue.

All the best,

Dr. Skourtis

Mia E. Skourtis, MD
Portland Plastic Surgeon
5.0 out of 5 stars 1 review

No reason not to have a tummy tuck (abdominoplasty) after 4 C-sections.

Many women have abdominoplasties after C sections.  The total number makes no difference.  The scar resulting from these deliveries is removed with the skin and fat of the tummy tuck. 

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 16 reviews

You can have a tummy tuck after multiple C-sections

It is possible to have a tummy tuck after having had four C-sections.  There may be a moderate amount of scar tissue in the area between your pubic bone and your belly button (umbilicus) however this should not compromise the tummy tuck surgery.  The surgeon must take special care in dissecting the scar tissue away from the underlying abdominal muscle/fascia. Then, the muscles need to be tightened (plicated) which will give a flatter appearing abdominal contour.

Please consult with a board certified plastic surgeon prior to scheduling a tummy tuck procedure.

Best wishes,

Dr. Bruno

William Bruno, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 220 reviews

Tummy-tuck after C-Sections can help re-align muscles

After 4 c-sections, you deserve a tummy-tuck.  The tummy muscles (rectus-abdominis) get stretched out from successive pregnancies, and part of them get cut (and heal with a scar) during each C-section.

A tummy-tuck is a good way to not only cut away the extra skin, but also to re-align those muscles into their proper pre-pregnancy shape.  This can help not only with a nice cosmetic outcome, but also with posture and strength.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.