C-Section Scar Revision Options? Excessive Pain and Bad Scar

Hi, I had a CS a year ago for failed induction. I am 22. My scar is thick, red and raised about a cm. It hurts a lot especially when I wear underwear. When I am out I almost pass out from the pain! My mom is a theatre sister and said it is the worst she has seen (and that she can't understand why my Ob "butchered" me). Will a revision correct the pain, and will I need to wait another 18 months before trying to conceive, or if the revision avoids the uterus can I TTC in the present 18m?

Doctor Answers 6

C-Section Scar Revision Options

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Unfortunately, some individuals develop thick, heavy red scars after any surgical procedure.  These scars are very sensitive and painful.  Surgical revision is definitely helpful and the addition of 5-Flurouracil into your new surgical scar may also prevent hypertrophic scar formation. The revision should be helpful in correcting the pain.

The uterus is not attached to the scar on you abdominal skin, and the revision surgery should not interfer with your ability to conceive.



Washington Facial Plastic Surgeon

Scar revision

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Yes, you are a candidate for scar revision. When the procedure is performed, close follow up is necessary with the likely need for silicone gel or sheeting and possible scar injection with medication. There is no guarantee that another bad scar will not develop.

J. Jason Wendel, MD, FACS
Nashville Plastic Surgeon
5.0 out of 5 stars 221 reviews

Options for painful bad C-section scar include 1540 laser and surgical revision

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Your symptoms sound like you have a Hypertrophic c-secton scar which is not uncommon.

While surgical revision with a minor Tummy Tuck will likely be required I would first try to lessen the pain and irritability of the scar.

While steroid injections have been used successfully for years they have a down side in terms of producing visible red blood vessels and thinning the skin.

Very severe Keloids do require excision and Electron Beam radiation immediately post op-however it is unlikely that you have a Keloid-your doctor will have to make this determination.

For most Hypertrophic Scars a more modern approach is the use of the 1540 Non ablative Erbium Laser. 4-5 treatments 6 weeks apart may be needed. In my experience this treatment reduces redness, scar bulk and improves comfort.

Once the scar is less inflamed and more stable-about 6 months, surgical revision with Tummy Tuck can be performed with better results

C-section Scar Revision?

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Thank you for the question.

Treatment of the symptomatic C-section scar may involve options including steroid injection or surgical excision ( and even superficial radiation treatment).

It would be in your best interest to be examined by a well experienced board-certified plastic surgeon to discuss each option and the potential risks/complications/success rates of each modality of treatment.

Best wishes.

Painful C-Section Scar

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A painful scar can happen after any surgery and it is not necessarily the surgeon's fault. Ask your doctor about a referral to a plastic surgeon and you can talk about about a revision (and possible nerve exploration if the pain is related a nerve trapped in scar tissue).

Karol A. Gutowski, MD, FACS
Chicago Plastic Surgeon
4.9 out of 5 stars 76 reviews

C-section Scar Revision Options

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First of all, different people make different scars and some patients are especially prone to making bad scars.  Therefore it is certainly possible that your OB did nothing wrong at the time of your C-section.  The way to increase the chances of having a good result would be to have the scar excised with injection of the wound edges with steroid and another medication with radiation therapy.  There is still are fairly high rate of recurrence of the keloid.

John Whitt, MD (retired)
Louisville Plastic Surgeon

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.