Tummy Tuck or Scar Revision for C Section Scar?

I have two children and my first child was an emergency c-section due to placenta privia and I got a vertical c-section as well as for my second child.

2 yrs had passed and I have been exercising for 3 months now everyday and still can't get rid of the pouch. I'm not fat and I don't have alot of belly but my question is can I get a bikini Tummy tuck without all the large scars from hip to hip or would a scar revision be better if I want the tummy tuck scars on the bottom be like a horizontal c section?

Doctor Answers (77)

No tummy tuck scar revision possible but there are risks

+9

You look excellent! You do not need a tummy tuck and another scar!

Vertical scar revision is possible but there is always a chance that the new scar will not heal well even if done by a plastic surgeon.

A complex but very nice scar correction of a vertical c-section scar is pictured here. This scar was depressed or contracted which is a very common result when a scar like yours is just cut out and sutured closed.

In this patient I removed the scar and then used SlimLipo laser assisted liposuction to flatten the fatty areas around the depression so that the area would heal smoothly without contraction and a depression-the result was excellent.

This is a lot of trouble for you to go through, but if you really want to improve the scar, that is the technique I would use.

I do not think you have enough excess skin to have a tummy tuck to adequately remove the scar.


Boston Plastic Surgeon
5.0 out of 5 stars 36 reviews

Tummy Tuck and Vertical Scar

+4

Dear dreyes,

I wish I had your tummy!  Congrats on a great figure after 2 children! Based on your pictures, I would likely tell you not to waste your money, and just enjoy being with your kids.  If you really pushed me, I could be talked into revising your vertical scar and tightening your 6-pack muscles through this same incision.  Some lipo of your lower abdomen and flanks would be done at the same time.  Of course, you would really have to push for surgery to get me to do this.  Congrats again.

Sincerely,
Asif Pirani, MD, FRCS(C)

Asif Pirani, MD, FRCS(C)
Toronto Plastic Surgeon
5.0 out of 5 stars 28 reviews

Liposuction and scar revision

+4

By your picture it appears that you have good skin tone with a darker skin color. Although it's difficult to truly appreciate the scar it does appear widened and hyperpigmented. In addition you do have some extra fat of the abdomen and lower abdominal protrusion "the pooch."

I think you would get a fantastic result with liposuction of the abdomen and flanks. Then using the vertical scar remove any extra skin and tighten the abdominal muscles below the belly button. The scar would be better as it would be closed in many more layers, thus less tension.

A horizontal incision would only add scarring. And since the entire vertical scar would not be able to be removed there's no sense in adding additional scarring.

Christopher L. Hess, MD
Fairfax Plastic Surgeon
5.0 out of 5 stars 19 reviews

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Standard Abdominoplasty or Scar Revision

+3

You look fantastic after two vertical C-sections.  Your skin tone is of a darker color and more easily prone to hyperpigmentation, which makes the vertical C-section scar more visible. The lower part of your abdomen shows separation of the rectus muscles, which makes your lower abdomen "pooch".  The only way to completely remove the vertical C-section scar is with a full abdominoplasty, which really just trades one scar for another.  Also, it appears you may not have enough skin laxity to have a full tummy tuck without leaving a very long horizontal scar.  Your have some extra fatty tissue on the abdomen and hip area which would benefit from liposuction. 

My recommendation is  a scar revision of the vertical C-section scar, to minimize scarring. At the time of the scar revision I would repair the rectus diastasis below your umbilicus. By pulling these muscle more closely together, the tension on the vertical scar revision is minimized and should give you an excellent result. I would also liposuction your hips, waistline, and upper abdomen at the time of the vertical scar revision and rectus muscle repair.

 

 

Rondi Kathleen Walker, MD
Washington Facial Plastic Surgeon
4.5 out of 5 stars 13 reviews

Tummy tuck vs scar revision- a common question

+2

Routinely patients ask if a scar revision will have an effect of a tummy tuck. As expected, the answer is NO. A scar revision will only address the immediate area of the scar. A tummy tuck will not only re-orient a vertical scar into a horizontal one, tighten the abdominal muscles, remove excess skin but also remove excess fat. Which procedure to have always depends on what the patient's expectations are and which surgical procedure can meet them. Most importantely, the discussion about the patient's expectations must take place BEFORE the surgery takes place!

Z. Paul Lorenc, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 24 reviews

To make an omlette

+2

Congratulations on your children, and your good work in the gym. You look great!

Now for the scar issue. I see this quite a bit, and your scar is actually not that bad. That said, the quality of a scar depends on how it is made, and how it is oriented regarding natural skin wrinkles. Unfortunately, the vertical scar is perpendicular to the natural wrinkles, and will tend to form a less attractive scar than a tummy tuck scar.

At two years out, you scar is mostly what it will ever be. A scar revision may give you some improvement, and that may be good enough for you. A tummy tuck will remove all the tissue basically between the pubis and the navel. The scar will likely be from hip to hip, in order to get rid of the midline scar.

Fortunately, there will be many other aesthetic benefits, and the scar will tend to be better than the midline.

So, you need to decide how to go. You may also choose to do nothing. But to make an omlette...

sek

Scott E. Kasden, MD
Dallas Plastic Surgeon
4.5 out of 5 stars 51 reviews

Tummy Tuck vs. Scar Revision

+2

I would look at it this way, the reason to have a tummy tuck would be to remove your stretch marks and to help flatten your abdomen. The removal of the vertical scar is possible at the expense of a horizontal incision along the same area of your c-section but longer, likely from hip to hip.

Othewise I would just recommend revision of your vertical scar incision.

Hope that helps.

Farbod Esmailian, MD
Orange County Plastic Surgeon
5.0 out of 5 stars 44 reviews

Customized tummy tucks

+2

Many patients fall into the grey zone between a mini tuck (with scar revision) and a full tummy tuck. Their fascia is loose, causing a bulge, Yet they do not want or need a hip to hip incision.
For those patients, a Hybrid tummy tuck (TM) may offer a solution: full fascial tightening, revision of the C section with a moderate removal of skin, no umbilical incision.
Because the umbilicus is tethered naturally, specialized endoscopic equipment or bariatric instruments are often required for exposure during surgery.

Brent Moelleken, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 99 reviews

C-section scar improvement

+1
Abdominoplasty, or tummy tuck, is a great procedure for removing loose skin and tightening abdominal muscles especially after pregnancy. It does not appear as if you have sufficient loose tissue to perform a standard abdominoplasty with a lower transverse incision. A combination of liposuction and a lower or mini tuck may provide you with the best result by removing some loose tissue, tightening your muscles, and removing a portion of your vertical scar. Discuss your options with your plastic surgeon.

Andrew Goldberg, MD
Fairfax Plastic Surgeon
4.0 out of 5 stars 3 reviews

Full Abdominoplasty vs Limited Incision Abdominal Wall Tightening

+1
It’s an excellent question. It’s very common to see patients who have had previous surgeries and are now exploring options for a tummy tuck surgery.

A “full” tummy tuck typically performs two things. It uses an incision that is low on the abdomen to remove excess skin and fat. It also allows the surgeon to tighten a loose abdominal wall. Abdominal laxity (also known as diastasis recti) is common after a pregnancy. In order to make room for the pregnancy, the abdominal wall stretches. Unfortunately, after the pregnancy, the abdominal wall doesn’t always return to its original tightness. During an abdominoplasty the surgeon can use sutures to retighten the abdominal wall. This helps flatten the abdominal wall and narrows the waistline.

There are many women who have worked very hard in the gym, but who are still having trouble obtaining a flat tummy. If someone were to stand in the mirror, and completely relax their abdominal muscles, they can often get a sense of whether the underlying abdomen is loose. Even when there is not much skin to excise (as in your case), tightening the abdominal wall can help with flattening the stomach. The abdominal wall can be tightened using a smaller incision that is placed low on the abdomen so that it is concealed by a bathing suit or underwear. This incision is about half the size of a full tummy tuck incision.

During the tummy tuck surgery the surgeon can often revise, or remove, previous surgical scars depending on where they are located on the abdomen and how much skin they expect to remove. Consultation with your plastic surgeon will help determine whether these options are right for you.

Austin Hayes, MD
Portland Plastic Surgeon

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