Loose Skin Due to Complications During Csection. Will My Lower Abs Ever Tighten?

a year and a half ago I had a baby. it was my second c section and the doctor had to cut my stomach muscles because they had fused to my bladder apparently because of first c section. I gained 60lbs my last pregnancy and weighed in at 200lbs right after I had baby. i am now down to 130. i am 5 foot exactly. my question is i do ab excerise daily but will i ever be able to tighten my lower abs back to normal since they had to be cut ?

Doctor Answers 10

Muscle injury due to C-Section

In most situations such as your, the answer would be highly doubtful. Pregnancy alone can injure the muscle to such a degree that it will always be lax. Adding a C-section that may have additionally weaken the muscle usually requires surgery to help restore a tight contour.


Robin T.W. Yuan, M.D.

Beverly Hills Plastic Surgeon
5.0 out of 5 stars 10 reviews

Tightening abdominal wall

You are 5'0 and weigh 130 lbs, so your BMI is about 25.5 (slightly overweight).  Exercising can be done to increase muscle tone and strength.  However, you have damaged your fascia (soft tissue surrounding the muscles) which is not repaired by exercise.  I recommend an abdominoplasty with mesh reinforcement.  This mechanically strengthens your abdominal wall, creasts a more hourglass figure, helps you lose weight and maintain the reduced weight.

Best of Luck,

Gary Horndeski, M.D.

Gary M. Horndeski, MD
Texas Plastic Surgeon
5.0 out of 5 stars 177 reviews

Ab Muscles after C-section

Thank you for your quiestion. 

During prenancy your rectus muscles get spread apart.  The addition of a C-section at the time of delivery can further this seperation.  This creates a rectus diastasis.  While exercise can strengthen the muscles, it won't bring them back to the midline where they anatomically should be. 

An abdominoplasty will correct this diastasis and help flatten out your stomach they way you want it to be.

Seek out an experienced board certified plastic surgeon to help guide you through this process.

Best Wishes,

Dr. Brian Joseph 

Brian Joseph, MD
Orlando Plastic Surgeon
4.5 out of 5 stars 42 reviews

Csection in 100% cases the rectus muscles must be cutted and repaired

you would need an abdominoplasty to repair the flappy lower ab, besides to repair the diastasis, but also you may go to the gym in a few weeks  after this kind  of surgery, than may be realized together  with a lypo, the results  are quite satisfactory

Ramon Navarro, MD
Mexico Plastic Surgeon

Ab exercises to tighten the abs after a c-section

Unfortunately, it sounds like you have diastasis recti where the muscles have separated, compounded by further separation from the c section surgery.  This is very common after having a few kids and even after c-section surgery.  No amount of abdominal excercises will help you bring your abdominal muscles back to the mid-line because it is the actual fascia or covering of the ab muscles that has separated and not the actual muscles.  There are no exercises that can tighten fascia.

The good news is that a tummy tuck solves this problem readily and that it is a common and safe procedure that is performed very frequently.  Find a board certified plastic surgeon and you will likely be extremely happy with your results.

Nikesh K. Patel, MD
Freehold Plastic Surgeon

Tightening lower ab muscles after C=sections

You can do all the crunches and sit-ups you wish, but you won't be able to tighten and strengthen your ab muscles until the separation between them is repaired surgically.

Michael Leff, MD
Bellevue Plastic Surgeon
5.0 out of 5 stars 8 reviews

Treatment of abdominal laxity

With your history, you will require an abdominoplasty with muscle plication to correct your problem.  See a board certified Plastic Surgeon.  Donald R. Nunn MD  Atlanta Plastic Surgeon.

Donald Nunn, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 17 reviews

Abdominal muscles after c-section

If your muscles have been spread, not only from the c-sections but during the pregnancies, the separation will not respond to exercise. This is an indication for abdominoplasty during which the muscles are tightened and the excess skin is removed. See a board certified plastic surgeon in consultation to discuss this procedure.

Robert L. Kraft, MD
New York Plastic Surgeon
5.0 out of 5 stars 17 reviews

Strengthening muscles may not improve your situation

There is a relatively common misconception among patients who have had a c-section that their lower abdominal bulging is due to the cutting of muscles.  In this day and age, most c-sections are performed with a pfannenstiel incision.  Although the outer incision is horizontal, the deeper layers are divided vertically, sparing the muscles.  Typically lower abdominal bulging after pregnancy comes from a stretching or tearing of the fascial layer (rectus diastasis).  This causes the rectus muscles to sit more laterally allowing the center of the abdomen to bulge.  No amount of strengthening of the abdominal muscles can fix this situation.  During a tummy tuck the rectus diastasis is corrected using large permanent sutures that act as an internal girdle.

Kelly Gallego, MD, FACS
Yuba City Plastic Surgeon
5.0 out of 5 stars 39 reviews

Abdominal muscles after C section.

Usually the muscles are not cut or transected, just separated for C sections. In most cases you can still strengthen the muscles, but they are separated (diastasis recti). This separation cannot be improved with abdominal exercises.

That is the beauty of a tummy tuck or abdominoplasty as the extra skin and fat are removed (often times the old C section scar) and the muscles placed back into better central alignment which gives a much flatter appearing tummy and can occasionally help with back pain or very mild urinary incontinence.

Brian J. Lee, MD
Fort Wayne Plastic Surgeon
5.0 out of 5 stars 11 reviews

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.