Loose Skin Due to Complications During Csection. Will My Lower Abs Ever Tighten?

a year and a half ago I had a baby. it was my second c section and the doctor had to cut my stomach muscles because they had fused to my bladder apparently because of first c section. I gained 60lbs my last pregnancy and weighed in at 200lbs right after I had baby. i am now down to 130. i am 5 foot exactly. my question is i do ab excerise daily but will i ever be able to tighten my lower abs back to normal since they had to be cut ?

Doctor Answers 11

Loose Skin Due to Complications During Csection. Will My Lower Abs Ever Tighten?

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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. 

Muscle injury due to C-Section

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In most situations such as your, the answer would be highly doubtful. Pregnancy alone can injure the muscle to such a degree that it will always be lax. Adding a C-section that may have additionally weaken the muscle usually requires surgery to help restore a tight contour.


Robin T.W. Yuan, M.D.

Robin T.W. Yuan, MD
Beverly Hills Plastic Surgeon

Tightening abdominal wall

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You are 5'0 and weigh 130 lbs, so your BMI is about 25.5 (slightly overweight).  Exercising can be done to increase muscle tone and strength.  However, you have damaged your fascia (soft tissue surrounding the muscles) which is not repaired by exercise.  I recommend an abdominoplasty with mesh reinforcement.  This mechanically strengthens your abdominal wall, creasts a more hourglass figure, helps you lose weight and maintain the reduced weight.

Best of Luck,

Gary Horndeski, M.D.

Gary M. Horndeski, MD
Texas Plastic Surgeon
4.6 out of 5 stars 230 reviews

Ab Muscles after C-section

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Thank you for your quiestion. 

During prenancy your rectus muscles get spread apart.  The addition of a C-section at the time of delivery can further this seperation.  This creates a rectus diastasis.  While exercise can strengthen the muscles, it won't bring them back to the midline where they anatomically should be. 

An abdominoplasty will correct this diastasis and help flatten out your stomach they way you want it to be.

Seek out an experienced board certified plastic surgeon to help guide you through this process.

Best Wishes,

Dr. Brian Joseph 

Brian Joseph, MD
Orlando Plastic Surgeon
4.8 out of 5 stars 52 reviews

Csection in 100% cases the rectus muscles must be cutted and repaired

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you would need an abdominoplasty to repair the flappy lower ab, besides to repair the diastasis, but also you may go to the gym in a few weeks  after this kind  of surgery, than may be realized together  with a lypo, the results  are quite satisfactory

Ramon Navarro, MD
Mexico Plastic Surgeon

Ab exercises to tighten the abs after a c-section

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Unfortunately, it sounds like you have diastasis recti where the muscles have separated, compounded by further separation from the c section surgery.  This is very common after having a few kids and even after c-section surgery.  No amount of abdominal excercises will help you bring your abdominal muscles back to the mid-line because it is the actual fascia or covering of the ab muscles that has separated and not the actual muscles.  There are no exercises that can tighten fascia.

The good news is that a tummy tuck solves this problem readily and that it is a common and safe procedure that is performed very frequently.  Find a board certified plastic surgeon and you will likely be extremely happy with your results.

Nikesh K. Patel, MD
Freehold Plastic Surgeon
5.0 out of 5 stars 21 reviews

Tightening lower ab muscles after C=sections

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You can do all the crunches and sit-ups you wish, but you won't be able to tighten and strengthen your ab muscles until the separation between them is repaired surgically.

Michael Leff, MD (retired)
Bellevue Plastic Surgeon

Treatment of abdominal laxity

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With your history, you will require an abdominoplasty with muscle plication to correct your problem.  See a board certified Plastic Surgeon.  Donald R. Nunn MD  Atlanta Plastic Surgeon.

Donald Nunn, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 51 reviews

Abdominal muscles after c-section

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If your muscles have been spread, not only from the c-sections but during the pregnancies, the separation will not respond to exercise. This is an indication for abdominoplasty during which the muscles are tightened and the excess skin is removed. See a board certified plastic surgeon in consultation to discuss this procedure.

Strengthening muscles may not improve your situation

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There is a relatively common misconception among patients who have had a c-section that their lower abdominal bulging is due to the cutting of muscles.  In this day and age, most c-sections are performed with a pfannenstiel incision.  Although the outer incision is horizontal, the deeper layers are divided vertically, sparing the muscles.  Typically lower abdominal bulging after pregnancy comes from a stretching or tearing of the fascial layer (rectus diastasis).  This causes the rectus muscles to sit more laterally allowing the center of the abdomen to bulge.  No amount of strengthening of the abdominal muscles can fix this situation.  During a tummy tuck the rectus diastasis is corrected using large permanent sutures that act as an internal girdle.

Kelly Gallego, MD, FACS
Yuba City 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.