Is it possible to get a flat stomach again after a c-section without the surgery?

It is impossible to answer this question without examining you or seeing photos.  Lots of women can certainly get a flat tummy.  The flat tummy really needs three things: little fat (this can be obtained for many people with nutrition and exercise); tight skin (this is harder to correct without surgery and really depends how much laxity developed during pregnancy) and muscles that are not too far apart (the fascia that holds the 6-pack rectus muscles close to the midline stretches as the uterus grows; the extent of this varies.  If it is too far apart then often a bulging is noted when you aren't sucking in.  This is best treated surgically if extensive.)  It just depends on your situation.

  A tummy tuck may help, but pictures or an exam would be necessary to make that determination.Kenneth Hughes, MDLos Angeles, CA

 Thank you for the question. Online consultants will be much specific to without viewing photographs or in-person evaluation. However, some general thoughts may be helpful to you.

For most patients who have had pregnancies and/or weight loss a full abdominoplasty is necessary to achieve the desired results. The tummy tuck operation serves to re approximate muscles that may have spread with pregnancy and/or weight gain/loss, remove "excess" skin/adipose tissue (often overhanging C-section scars) and further contour the abdominal wall, with tools such as liposuction surgery.

Generally speaking, the “ideal” patient for tummy tuck surgery is one who has completed pregnancies, is psycho socially/emotionally/financially stable, has an excellent social support system surrounding him/her, is capable of arranging enough recovery time, does not smoke and who has reached a long-term stable weight.

Of course, there are downsides (including a longer scar and probably a longer recovery time) but for most patients the benefits outweigh the downsides.

You will also hear/read about mini tummy tuck surgery. In my opinion/experience, the mini tummy tuck is an operation that produces very limited results and is very rarely indicated. It involves a shorter incision but does not address the majority of the abdominal wall issues present for most patients who present consultation. For example, the area of skin excised is quite small. The abdominal wall musculature is addressed below the umbilicus leaving the upper number wall potentially lax. The appearance of the umbilicus is not necessarily addressed sufficiently.
Again, for the vast majority of patients who have had pregnancies and/or weight loss a full abdominoplasty is necessary to achieve the desired results. When the time is right, seek consultation with board-certified plastic surgeons who can demonstrate significant experience helping patients achieve the types of outcomes you would be pleased with. You may find the attached link/video, dedicated to tummy tuck surgery concerns, helpful to you as you learn more. Best wishes.

Hi Aries33, Yes it is possible but may require a lot of work.  If you have gained weight  diet and exercise so you are back to your prepregnancy weight will be necessary. If you have significant stretch marks or wrinkled skin and if skin hangs over the C-section scar then these things will most likely not be corrected with just diet and exercise. A consultation with a plastic surgeon will help determine if surgery is necessary.

Once the rectus muscle has been cut during the C-section and has laxity, your stomach cannot be flat unless you have a tummy tuck.  Many women bounce back reasonably after one Caesarean but it is the second or third one that leaves their abdomens irrevocably loose and aesthetically unpleasing.