Will Vaser Lipo help with my c-section dome-shaped lower belly? (Photos)

Question

I’m now 40 years old and I had 3 c sections one after the other basically . I have managed to loose all my baby weight again but after my last pregnancy I’m left with a dome shaped belly and quite an apron style lower stomach due to scars . Iv always been really slim so I really can’t get used to having a belly sticking out especially when the rest of me is very slim it looks odd . My youngest is 3 now so I can’t see my belly going any flatter I’m trying weights and Pilates not sure what’s best

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question and for sharing your photos. Based on your history and images, it appears that your primary issue is a weakened rectus abdominis muscle, likely caused by multiple pregnancies and your C-section deliveries. This weakened muscle results in the "dome-shaped" appearance of your abdomen. Unfortunately, liposuction alone, even VASER lipo, will not address the root of the problem because it only removes fat, and you do not seem to have excess fat in this area.

A tummy tuck, or abdominoplasty, would be the most effective surgical solution for your concerns. During this procedure, the incision is placed below your existing C-section scar, allowing removal of the scar tissue and creating a flatter and smoother lower abdomen. The skin is then elevated to the rib cage, and the rectus abdominis muscles are repaired with permanent sutures to bring them back together. This muscle repair is crucial for flattening the "dome" and restoring a tighter abdominal contour.

Since you have minimal excess skin or fat, the focus would be on repairing the muscle to achieve the best aesthetic outcome. It is also worth noting that Pilates and weights, while beneficial for overall strength and health, will not tighten separated abdominal muscles or significantly change the contour of your abdomen if the issue is related to diastasis recti.

While VASER lipo is a great option for reducing fat, it would not address your muscle separation, and therefore, it would not resolve your primary concern. I strongly recommend consulting with a board-certified plastic surgeon who specializes in abdominoplasty to achieve the results you desire.

Sincerely,
Dr. J. Timothy Katzen, MD, FASMBS, FICS

Jerimiah Mason, MD · Answer

I don't think Vaser is necessary, but you might benefit from a mini tummy tuck to excise the loose skin.  The scar probably would be even lower than your c-section scar, and only a little wider.  The only other thing I would consider would be some mild liposuction with a skin tightening device like Renuvion.

Andrew Ray, DO · Answer

The reason your abdomen is doming a little like that is because of abdominal wall laxity. This is because of multiple pregnancies and the trauma of 3 different c-sections. The great thing is that you don’t appear to have that much skin laxity. My suggestion would be to do a lower abdominal muscle repair or diastasis repair using the same incision that was made for your c-section. Your abdomen would flatten out, and you could remove a small trip of skin to make sure everything stays smooth.

Jonghyun Hong, MD · Answer

Hello Dear Humorous190941, It is Dr. Hong from Fresh Plastic Surgery Clinic South Korea, Seoul. Based on pictures , it is hard to state anything with 100% confidence. However, what I would like to mention is : many people get wrong about Vaser Lipo, Vase or any traditional liposuction has somehow lifting effect due to "bio-bond" phenomenon, however it is possible in case if area of liposuction was not already sagged. So, depend on present situation there might be several options : like having liposuction and then some skin tightening laser after (if it problem of skin and fat)/ or do tightening laser first if there is not much fat (if problem of skin elasticity), abdomenoplasty with muscles reconstruction (if it is about skin and muscles) and etc. 
Hope my answer will be helpful. Best Regards, Dr. Hong

Arif Eroglu, MD · Answer

Hello; the diastasis in your abdominal muscles; so, there is separation and powerlessness. It is not possible to fix this; by the support of pilates or sports activities. Muscle repair must be needed. In the upper abdomen area, your skin is loose; if you have stretch marks and sagging in your lower abdomen field; while performing a Tummy Tuck, muscle repair could also be realized. However, since you do not have excess skin; for you from the lower abdomen; by making 3 incisions; Laparoscopic abdominal muscle repair can be organized or abdominal muscle repair can be implemented simultaneously with Mini Abdominoplasty.

Mats Hagstrom, MD (license on probation) · Answer

Treatment options should be based on having a clear understanding of the underlying ideology.
There are four tissue valuables that can determine what the abdomen looks like.
Depending which of these variables is causing the problem, dictates what the best treatment option would be.
The four variables that determine what the abdomen can looks like are the following.
1) abdominal skin laxity due to previous pregnancies or substantial weight loss.
2) excess subcutaneous fat
3) muscle separation from previous pregnancies
4) excess visceral or intra-abdominal fat.
In your case, the primary problem is muscle separation followed by a slight bit of skin laxity.
In regards to treatment options at tummy tuck primarily treats abdominal skin, laxity, and muscle separation.
Liposuction reduces excess subcutaneous fat. Excess this rat can only be reduced through weight loss.
In your case because the problem is primarily muscle, separation and skin, a full tummy tuck is the correct procedure.
There is no other treatment for muscle separation due to previous pregnancies.
Consult with plastic surgeons in your community to get a better understanding and a more accurate assessment.
Best,
Mats Hagstrom, MD

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