What happens during a full TT if I have adhesions from old C-section?

Question

Healthy, age 50, 5' 6", 128#. Had C-section 1997. Hoping TT will remove excess fat & improve muscle strength. I think I may have adhesions as I get pain along C-section scar line with any lower ab exercises during and after that lasts for days to the point I must avoid them. Also have lower back pain due to poor ab muscle tone. Wearing ab girdle helps, so hoping TT will solve both issues, but concerned what happens during surgery & if risks are increased due to adhesions? Thanks.

Nelson Castillo, MD · Answer

Some women develop scar tethering as a result of their C-section which can be improved and corrected upon with a full tummy tuck procedure.  It poses increased risk of bleeding but this is not an uncommon situation that is addressed with tummy tucks.  Hope this helps.

Robert P. Schmid, MD · Answer

Thanks for your question! It's a little hard to answer your specific question as it pertains to yourself, without the benefit of your photos, but I can say that YES, tummy tucks usually will break up those old scar adhesions & give you a much more even, flatter appearance. 
I certainly don't guarantee my patients that it the surgery will alleviate their adhesion scar pains, but it does in fact usually happen. Best of luck to you!

Ashley B. Robey, MD · Answer

An abdominoplasty would be a nice way to address the excess skin of the abdomen and abdominal muscle separation (diastasis). When you have a separation of the abdominal musculature, it can put more stress on the lower back muscles. Restoring normal anatomy should be helpful in that regard, but there are no guarantees that a tummy tuck would resolve your lower back pain. The tethered skin around the C-section scar would be removed. A tummy tuck surgery would not typically involve any structure deep to the muscles, so pelvic or intra-abdominal adhesions should not put you at increased risk. 
Best of luck!

Bradley A. Hubbard, MD · Answer

Thanks for your question! We do see a lot of c-section scars on our tummy tuck patients. The scar tissue in the skin and the scar above the muscle is never severe enough to cause a problem, with one exception: a hernia. Assuming you don't have a hernia below your c-section scar, the surgery should be uncomplicated. 
As for treating abdominal pain in the area of the scar, I am not as sure. I always want to understand the reason for pain before promising it will go away. It is pretty atypical to have pain in a scar this far after the c-section. This make me wonder about a hernia again...
The loss of core strength will improve after rectus diastasis correction. Best of luck!
BH

Kenneth Hughes, MD · Answer

A tummy tuck scar is usually below the C-section scar, so the scar tissue can be addressed at the time of the tummy tuck.

Keith Hodge, MD · Answer

During a tummy tuck, the incision is usually made below the C-section scar. Therefore, all the scar tissue surrounding the scar is removed during the resection of the excess skin and fat in the lower abdomen. The muscles are also tightened which helps your back if you have a diastasis (muscle separation). I will also combine this with liposuction in most patients. Good luck!

Andres Taleisnik, MD · Answer

Many women who undergo tummy tucks have had c-sections, often with adhesions. It's not an issue. Your surgeon will divide the skin from the adhesions, and will usually excise (cut out) the prior c-section scar completely. This could very well improve the pains you experience, but no one can guarantee that.

Vishnu Rumalla, MD · Answer

Thanks for your inquiry.  Your symptoms you experience could also be a sign of a hernia.  I suggest you let your surgeon carefully exam you and make sure you do not have a hernia.

Christian A. Prada, MD, FACS · Answer

The c-section scar is removed at the time of the TT so don't worry about adhesions.  You will have a completely new scar that looks typically much nicer, and lower than your previous scar.  The pain should also go away after the scar is removed.  I'm happy to see you in the office to evaluate.  Good Luck!

Jonathan Amspacher, MD · Answer

Hello and thanks for your questions.  In most cases the incision for a tummy tuck will be drawn below any old C-section scar. This will remove any scar tissue that is anterior the rectus muscles. This improves the symptoms that you describe in many patients, but not in every one. If your pain is from adhesions or something else deeper in the abdominal cavity the tummy tuck will not improve those issues. The primary function of a tummy tuck is improvement in shape and contour but many patients will also get some functional improvement as well. Best of luck on your journey.

Jeffrey A. Sweat, MD · Answer

A full tummy tuck incision usually is placed below your old c-section scar so that the scar and any adhesions will be removed during the course of the surgery.  If, on the remote possibility, there is a hernia or other problem present, your surgeon should be able to fix that as well.  A well trained plastic surgeon with appropriate experience should have no problems doing your tummy tuck.  Best of luck!

What happens during a full TT if I have adhesions from old C-section?

Answers (18)

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