C-section scars can sometimes pull, elicit pain, or cause rashes from their indentation. Revising these problematic scars to a more flat appearance can be a quick way to improve the appearance of your lower abdomen.
This type of procedure might be right for you if you've ever said:
“My scar has always been indented”
“The scar isn’t even and is higher on one side”
“My scar is painful and I get rashes there”
Cesarian sections are a very common procedure and sometimes, unfortunately, the scar may not heal well. These scars can not only be visually unpleasant, but can also cause functional problems such as pain, rashes, or acting like a clothesline that allows excess abdominal skin to fall over it. The most common reason for unhappiness with a c-section scar is when the scar is indented or depressed and causes the skin around it to look like it’s bulging. This depression of the scar can lead to moisture accumulating, which leads to rashes. Proper closure of a c-section incision in layers reapproximates both the skin edges as well as the underlying supporting fascia that prevents the skin from adhering to the underlying tissue causing the depressed scar.
The problem
Scar revision of a c-section incision begins with identifying what the problem is. Hypertrophic or thickened scar can result from poor closure or chronic irritation from hair or clothing rubbing the incision. In this case, excision of the scar at the level of the skin and meticulous closure may be all that is necessary. If the scar is deep, then more tissue would need to be removed to reach the deeper fascia and appropriately repair the Scarpa’s fascia.
The method
C-section scar revision is almost always performed in the clinic with numbing medicine. If the procedure is combined with other larger procedures, you could consider having this done in the operating room under general anesthesia. The procedure involves numbing the skin and fat below and carefully removing all of the scar tissue from the level of the skin down as far as it goes. In some more extensive scars, the scar tissue can go from the skin down to the abdominal wall and cause pulling sensations or pain. In those cases, removing all of the scar tissue is critical to minimize the risk of pain or pulling afterwards.
After removing all scar and getting to healthy tissue, a layered closure as described above is performed to perfectly align all of the different tissue planes. The incision takes about 10-14 days to heal before you are able to return to aerobic exercise or heavier lifting. Most patients experience little downtime from this procedure.