Slim Lipo for C-section Pouch?

Question

I had my baby about 14 months ago via c-section, and have lost all my pregnancy weight. I'm actually in great shape with about 20% body fat only, but I have a tiny trouble area which I have learned is the 'c-section pouch'. Liposuction would probably be too much for me since it's such a tiny spot and very localized,and I don't want saggy skin afterwards (i have no saggy skin now). Is Slim Lipo a good choice? Are there alternatives or different procedures??

Philip S. Schoenfeld, MD, FACS · Answer

Although Slim Lipo is relatively new technology, it has proven to be quite effective in the right clinical situations. I would agree that liposuction of a small deposit of fat in what sounds like the area above your pubic bone may be more than you need. The Slim Lipo procedure can be performed under local anesthesia and is very good at addressing small pockets of fat and tightening the skin from where the fat was removed. It can also be used in larger deposits of fat but at 20% body fat for a female, that does not sound like what you are dealing with.

Tom J. Pousti, MD · Answer

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.

Chase Lay, MD · Answer

this is a great question because it's very commonly asked.

	It really is a small area above your C-section scar I'd say you can expect very good results.  Slim Lipo does a very nice job of lysing or melting fat while tightening the skin. It's not a gimmick or marketing scheme and should be used by experienced surgeons. Even though it may sound like it's not particularly invasive, and in many respects it is not, it should be used with caution because what is coming out of the end of that fiber optic truly is a laser melting fat in tightening dermis. That being said you should do well and even if you feel like you look better after month you may be surprised to find that you look better at three months and six months if you keep up your workout routine. I would not say that your skin would be perfectly smooth afterwards I would not expected to be particularly loose either. Of course the optimal plan may be Slim Lipo along with a mini tummy tuck. Both of these things can be performed under local anesthesia and have around 1 to 2 weeks worth of downtime when you add the surgical component.

	I hope that was helpful.  Chase Lay MD

Deason Dunagan, MD (in memoriam) · Answer

Slim lipo should help the skin in that area. However, it certainly does not guarantee the entire pouch will go away since to some degree the pouch is created from scarring.

Brooke R. Seckel, MD, FACS (retired) · Answer

SlimLipo laser assisted liposuction is very useful for carefully removing small areas of fat in otherwise thin fit people.However, the most common cause of a C-section pouch is contraction or tightening of the C-section scar which pulls upward, forcing the abdominal skin above the scar to fall over the scar forming a pouch.If this is what has happened ot you then a revision of the scar-a simplified mini tummy tuch is the best solution. I have also had luck using the Non-ablative 1540 fractional erbium laser on the scar to soften and release the scar.Slimlipo will not help the pouch if it is caused by contraction of the C-section scar.

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