C section shelf on one side - what are my options to fix this? (Photo)

Thank you for sharing your photos and explaining your experience so clearly. From what you’ve described and shown, it looks like the “shelf” you’re feeling is likely related to scar tissue formation and localized tissue adherence. After a C-section, it’s not uncommon for one side to feel different from the other, as the way tissue heals can be slightly uneven. This can create a small “bump” or shelf-like area where the underlying tissue is tethered to the fascia.

A few thoughts on your options:

Patience and conservative therapy

Scar tissue remodeling can continue for 12–18 months postpartum.

Techniques like massage, gentle stretching, cupping, and dry needling may help soften adhesions, though progress can be gradual.

Sometimes combining these therapies with silicone sheets or scar gels can help flatten and soften the scar over time.

Medical interventions

Scar revision: In some cases, a small revision can remove fibrotic tissue and re-close the incision for a smoother contour.

Mini tuck or panniculectomy: This is more of a surgical approach that can address uneven lower abdominal contour if there is loose skin contributing to the shelf. This would be a bigger procedure than a simple scar revision.

Injectable treatments: Some clinicians use small-volume steroid injections or enzymatic injections (like collagenase) to help soften particularly thick or fibrotic scar tissue, but this depends on the specific tissue characteristics.

Combination approach

Often, a combination of conservative therapy and a minor procedure yields the best aesthetic and functional outcome. For example, continued dry needling or massage can soften tissue first, and if it’s still noticeable after a year, a small revision can address the residual shelf.

The good news is that unevenness like this is fairly common and usually treatable. The choice between waiting, continuing non-surgical therapy, or considering a minor revision depends on how much the shelf bothers you and whether it’s causing discomfort.

It’s encouraging that you’ve already seen improvement with your current routine, so continuing gentle therapy while monitoring changes over the next few months can be worthwhile before considering surgery.

Our office has many different treatments for scars depending on the depth of atrophy or hypertrophy. Scars require a combination approach using our HI DEF protocol which uses a combination of lasers, topical scar modulation, and RF treatments to pixelate scars, improve contour, reduce hyperpigmentation, and improve the visibility of the scars so that they are no longer visible in ambient light. Everyone has a unique pattern of scarring and we employ our HIDEF technique to improve texture, color, contour, and topography. We often use a combination of treatments that begin with a careful examination to examine the micro texturing of the acne scars. Atrophic scars and indented scars can benefit from injectable fillers such as Radiesse, Sculptra, and Restylane with or without subcision to remove tethered scars and atrophic depression. Hyper-redness in scars can be improved with V beam laser, Excel V, BBL, IPL, and Venus RF to improve the redness and reduce the visibility of deep scars. Fractional Thulium laser and clear & brilliant can also reduce the inflammation and redness of the scar when combined with topical therapy. Fractional lasers such as Fraxel, erbium, and CO2 laser can be combined with radio frequency and also fractional RF to improve textual issues and microtopography. Subcision and TCA cross are also used for deep ice pick scars and narrow valley scars in order to improve the micro texture. Above all, our combination approach with our clinical nurses and board-certified plastic surgeons can improve the quality of your skin by using at home Melarase creams combined with PRP treatments in our office to improve your skin quality and tone. I recommend getting a formal evaluation with an experienced team of experts in order to reduce your scarring.


Finally, hyperpigmentation of scars can be improved with at-home Melarase AM, Melarase PM, and Melapads to help reduce active PIH and melanin deposition.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Based on your post photos, I would recommend a mini tummy tuck option to gain best control of your issues. Best of virtual concert with expect fees to range from $3500-$4500 to a high of $8500 again best of virtual consult with.