C-section shelf - Mini tuck, full tummy tuck, lipo, or scar revision? (Photos)

Question

I had 2 kids both via c-section. 36 female, with a bmi of 25. My main concern is the c-shelf. I am unhappy with the bulging there no matter how much weight I lose. I am not sure if I should do Mini tuck, full tummy tuck, or just lipo or a scar revision. I read that a scar revision might release the bulge.

Earl Stephenson, Jr., MD, DDS, MBA · Answer

Dear Raniung13,

From your photos and description, the main concern appears to be the “C-section shelf”—that small overhang or bulge above your scar. This is very common after childbirth, especially with prior C-sections, because the scar tissue tethers the skin while the surrounding tissue remains more mobile.
A few considerations:

Daniel Barrett, MD · Answer

Dear raniung13,

based on your photos, you look like a good candidate for a TT. Full tummy tuck should tighten your abdominal muscles and remove the excess skin. Flanks liposuction would give you a better shape. I would suggest you to consult a board-certified plastic surgeon because only after a thorough examination you will get more information and recommendations.

Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Jeffrey M. Darrow, MD · Answer

Thank you for your photos. If you’re only concerned is the small shelf above your C-section scar, a mini tummy tuck will remove the scar and flatten and smooth the roll.  If, however, you wish your entire abdomen to be smoother, flatter and tighter, then a full tummy tuck would be required.  Discuss these options with your plastic surgeon for an in-depth explanation of the benefits and risk of each.

Leila Kasrai, MD, FRCSC · Answer

If it’s just the bulge below your belly button that you’re concerned about, a mini tummy tuck would be sufficient.

Ira H. Rex III, MD · Answer

This has to be discussed with a plastic surgeon who specializes in tummy tucks.  The operation of choice fully depends on what your expectations are.  From your photographs, it seems you would be an excellent candidate for a full tummy tuck if you are ready to put a little more energy into the healing process.  Also, you would have to accept a longer scar.  It seems these might be a good trade off in your situation to get a very nice result.

Ellen Ozolins, MD · Answer

Thank you for your question. A post-C-section shelf typically consists of scar tethering, a small pad of subcutaneous fat, and lower-abdominal skin laxity. Liposuction alone won’t resolve tethering and may even worsen the overhang; simple scar revision is effective only if the skin is tight and the issue is solely a depressed scar. The most dependable correction is a mini tummy tuck that releases the C-section scar, removes lax skin below the umbilicus, and adds limited liposuction to the lower abdomen. Opt for a full tummy tuck instead if skin laxity, stretch marks, or diastasis extend above the umbilicus. You should have an in-person consultation with a board-certified surgeon to perform a pinch test, check for diastasis, and determine whether a mini abdominoplasty with targeted liposuction will meet your goals or if a full abdominoplasty is necessary.

Guray Yesiladali, MD, FEBOPRAS · Answer

The fullness above a C section scar is a very common concern, and it rarely improves with weight loss alone.
Scar revision by itself usually improves only the surface line and does not correct the bulge if there is extra skin or tissue underneath. Liposuction can reduce fat volume but will not tighten the skin, so if skin laxity is present the shelf effect may remain.
A mini tummy tuck can be effective when the issue is mostly limited to the lower abdomen. It removes the scar and the excess skin in that zone and flattens the contour. If there is more extensive skin laxity or muscle separation, however, a full tummy tuck is often the most complete solution.
The best choice depends on whether the problem is only excess fat, or also involves skin redundancy and muscle laxity. For many patients with a true C section shelf, surgery that removes and tightens the lower abdominal skin provides the most satisfying and lasting change.
I have also shared a detailed video where I explain the differences between scar revision, liposuction, mini tummy tuck, and full tummy tuck, with examples of how each can address this concern.
&mdash; Güray Yesiladali, MD

Gary M. Horndeski, MD · Answer

You appear to be a good candidate for a mini tummy tuck. This will tighten up the skin below the umbilicus, excise the scar and lower the scar towards the pubic area. It will also remove the anterior bulging.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Tuan A Truong, MD, FACS · Answer

Thank you for your question. Ultimately, the decision for these wonderful options you have presented is up to you. Scar revision alone will not address the skin redundancy or muscle laxity after 2 C-sections. A consultation with a board-certified plastic surgeon will narrow your choices and help optimize your decision to achieve your goals. Good luck on your journey!

Kamol Pansritum, MD · Answer

Based on your description and BMI, it sounds like there is some skin laxity in the lower abdomen, which likely won’t be resolved with liposuction or scar revision alone.I recommend a mini tummy tuck (mini lipectomy) to remove the excess skin and flatten the lower abdomen. This procedure targets the area below the umbilicus with a shorter incision and recovery time compared to a full tummy tuck.

C-section shelf - Mini tuck, full tummy tuck, lipo, or scar revision? (Photos)

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