C-Section Scar Revision

What is a c-section scar revision?

Following a c-section, many women experience a retracted or otherwise unsightly scar on their abdomen. In some cases, there is a bulge above the scar, or overhanging skin above the scar due to the fact that the scar is retracted. Additionally, the scar may be thick or raised, or all of the above may be present.

These phenomena occur because many doctors who perform c-sections are not trained in cosmetic closing techniques, and they are primarily concerned with the safety of the mother and the baby, which is appropriate. However, this means that all layers may not be properly closed after the procedure, resulting in a conspicuous or unsightly scar.

For women who have an unsightly scar following a cesarean section, our Los Angeles c-section scar revision is a method of removing or excising the old scar, as well as the scar tissue down to the muscle layer. C-section revision releases the tissues to their original position and closes them, restoring a smoother appearance on the abdomen and a thinner-looking scar. If you are unsatisfied with the appearance of the way your c-section scar healed, you may want to consider speaking to Dr. Rahban about this procedure as a part of your Beverly Hills Mommy Makeover.

Am I a candidate for c-section revision?

If you have a distinctly visible scar after a c-section that you would like to eliminate, you are likely a candidate for c-section scar removal. Patients undergoing a c-section revision generally experience one or more of the following:

• An inverted c-section scar
• A retracted or depressed scar, causing a flap of skin to fold over the top
• A c-section scar that has become red, raised or painful
• A c-section scar that has turned into a keloid
• A c-section scar that is prominent enough to be seen through clothing

If you are going to receive a tummy tuck or a mini tummy tuck procedure, c-section scar repair is often not necessary, as c-section revision is incidental to the mommy tuck procedure. A c-section revision by itself is a useful procedure for women whose abdomen is only tarnished by the c-section scar and is otherwise okay.

The c-section revision consultation

Note: while each surgeon approaches the consultation process differently, Dr. Rahban feels they should all have the same basic elements, ensuring patients leave very well informed regarding surgery. Below is how Mommy Makeover specialist, Dr. Rady Rahban, conducts a consultation.

Your consultation should be done by your plastic surgeon and not by his staff, such as his coordinator. In many cases, patients are offered free consultations, but you must understand that often means you’ll get a hurried consult. As a point of reference, Dr. Rahban on average spends up to an hour with each patient, reviewing not only what the patient came in for, but also explaining all the nuances such as the risks and alternatives to what that patient has requested.

There is no way to accelerate the dissemination of knowledge when it is so complicated and crucial.

During our Beverly Hills c-section revision consultation, Dr. Rahban covers several crucial points. Firstly, he gathers data regarding your specific cosmetic objectives. Second, after an examination, Dr. Rahban defines the exact problem, allowing you to better understand what your body has been through. Next, he lays out your options, including incisions, amount of scar tissues to be excised, and other factors involved in a c-section revision. He will determine if you need a c-section revision or a mini tummy tuck. In certain cases, a full tummy tuck may even be necessary to achieve the optimal result. He will explore every option and recommend the procedure he feels will best address your cosmetic issues.

As an extension of this, Dr. Rahban also reviews what patients should not expect from surgery. He is well known for telling his patients the truth and establishing a healthy level of expectation. Most patient dissatisfaction is related to inaccurate understanding and expectation of their surgery. Dr. Rahban deals in full disclosure to prevent this from occurring.

In the interest of helping his patients fully understand the procedure, Dr. Rahban will take this opportunity to review all potential risks. While some risks are quite unlikely, he still wants his patients to be aware of the potential downsides of a c-section scar revision. All surgeries come with risks. Therefore, he believes the only time to engage in surgery is if the benefits far outweigh the risks. If you will only have a mild improvement, Dr. Rahban will most definitely recommend you do not undergo the procedure.

During a consultation, Dr. Rahban has one primary purpose—total patient education. He wants each patient to fully understand the nuances of c-section revision, as well as every risk and exactly how the procedure applies to them, allowing them to make the best decision for themselves. With his honest, candid approach, Dr. Rahban brings a new level of care to ensuring his patients know exactly how a c-section revision works.

C-section revision procedure

Note: while no two surgeons perform this procedure identically, most techniques have a similar series of steps. Below is a brief overview of Dr. Rahban’s technique, allowing you to gain a more detailed understanding regarding how your surgery will be performed. The more you know, the more control you have.

Because a c-section scar revision is often a very minor procedure, Dr. Rahban may opt to perform it right in his office. This waives the necessity for fees associated with surgery, such as an anesthesiologist or time in the OR.

In removing a c-section scar, Dr. Rahban must remove all scar tissue down to the level of the muscle. He does this by undermining the scar itself, ensuring that all unsightly tissue is excised, leaving behind only healthy, fresh tissue from which to work. During this time, he may opt to remove some excess skin that may have become stretched out during pregnancy, also known as a mini tummy tuck, in which case it will be done in an operating room. He then meticulously closes the incision from the inside out, ensuring each underlying layer is perfectly lined up and evenly sutured together. As a result, the scar from Dr. Rahban’s incision is virtually invisible, requiring no further revision. This procedure generally takes an hour to perform.

Preparing for a c-section revision

In most cases, a c-section scar repair is done under local anesthesia right in Dr. Rahban’s office. It is a relatively minor procedure, not requiring the usual stringent protocol involved with surgery.

For patients receiving a c-section revision, preparation begins about two weeks before the procedure. Every patient goes through a thorough pre-procedure process. This begins with a visit two weeks prior to the procedure. This is similar to a second consult. During this time, you will go over the details of your procedure with Dr. Rahban, and you will get a second opportunity to ask questions and go over your procedure, thus ensuring a complete understanding.

In the world of plastic surgery, this second visit is unusual. However, because the first visit can sometimes be overwhelming, patients often come up with new questions latently. Dr. Rahban provides this second visit so his patients can be completely at ease with every question answered. During this visit, Dr. Rahban and his staff will thoroughly review all instructions prior to undergoing c-section revision.

If you have any questions prior to your surgery, our office is available to you. Call or email us any time, and we will help with anything you need. Our goal is total peace of mind for our patients, as well as a safe, successful procedure.

Healing and recovery

Note: the recovery listed below is according to Dr. Rahban’s routine. Other surgeons may have a different approach to the recovery process.

While a c-section revision is a relatively minor procedure, the post-operative care is as as important as a major tummy tuck. In order to ensure an optimal outcome, your body needs time to heal.

When undergoing a c-section revision, the healing process is crucial to a beautiful result. For this reason, our office will ask that you strictly adhere to our list of post-operative guidelines. We will give you a full list in our office, but below are several examples so you know what to expect.

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Wound and incision care

At the time of your procedure, your wound will be sterile, and it will be covered with a sterile dressing. Dr. Rahban will ask you to keep that dressing on for seven days. While some patients feel as though their wounds are getting dirty throughout that time period, it is exactly the opposite. Non-sterile materials such as fingers and water introduce bacteria that can cause infections. When you open your wound to clean it, you’re laying it open to the possibility of infection.

Because of the dressing, you should take sponge baths for the first week. This not only makes your life easier, but also helps ensure the incision doesn’t get infected. After that, Dr. Rahban will give you further instructions as far as maximizing your cosmetic outcome and minimizing your scars.

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Activity level

During the first week, Dr. Rahban recommends that you limit your activities to mild movement and refrain from fully resuming normal activities. You may be able to resume work, depending on the nature of your work. Additionally, there should be no lifting greater than 5 pounds and no cardio for 6 weeks. This prevents pulling on the scar, which is the number one cause for a poorly healed scar.

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Medication

You may have some mild to moderate discomfort for which you will receive pain medication. In addition, you will get antibiotics to assist with prevention of any infections.

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Surgical garment

A surgical garment is not necessary following a c-section scar removal.

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Surgical drains

Surgical drains are not necessary following a c-section revision.

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Follow-up

>After a c-section, Dr. Rahban schedules a total of five follow-up appointments. Most plastic surgeons schedule two follow-ups, during which time you may not even see the doctor. During every follow-up appointment, Dr. Rabhan sees his patients personally. He believes it is the patient’s responsibility to follow up with him. This is because patients may not know something is wrong until they see a professional. From Dr. Rahban’s viewpoint, plastic surgery is a team approach, and you must do your part by showing up to your follow-up appointments.

In addition to the pre-scheduled follow-up appointments, Dr. Rahban is available to his patients at any time after surgery. If there are any questions or concerns that arise, he and his office are available to help. Just give us a call and we will provide every bit of assistance.

Risks and complications of c-section revision

C-section scar revision risks include but are not limited to:

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Bleeding

This is a very rare complication. We have patients stop all medications that promote bleeding at least two weeks in advance, such as anti-inflammatories, aspirin and supplements including fish oil and flax seed.

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Infection

Also quite rare, infection is thoroughly combatted before, during and after surgery. The night before surgery, we have patients wash themselves with an antiseptic soap. We give patients antibiotics directly prior to surgery, as well as after surgery. Additionally, Dr. Rahban has very strict post-operative instructions regarding wound management that he believes reduces the risk of infection.

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Scars

While an inevitability of surgery, the issue is not whether you will have a scar, but rather the quality of your scar. The goal is for you to have a well-healed, faint or fair scar over time. Dr. Rahban takes several steps to minimize the unsightly scar that so many people worry about.

He believes in the 50-50 rule. Fifty percent of scar healing has to do with the technique of your surgeon’s closure, or how well the incised tissues are brought back together. The other fifty percent is the patient’s biology. Because a patient has little control over her biology, there is a lot of emphasis placed on your surgeon and his closure technique. While many surgeons place their emphasis on post-operative scar management, there is very little science that any of these modalities actually work. Therefore, Dr. Rahban focuses on an unusually fastidious closure technique to ensure that all tissues heal with minimal scarring.

Please refer to his timeline on wound management for more information.

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Dehiscence or wound separation

This can occur if the wound is closed too tight or not closed well enough. Additionally, this can occur if the patient exerts herself too early, before the wound has fully healed, putting tension on the wound.

C-section revision cost

There is no standard c-section revision cost as there are many unique variables. Below is a list of the elements that will determine the cost of your procedure so you understand what exactly you are paying for.

1. The skillset of your surgeon. Is he or she a plastic surgeon or a cosmetic surgeon? Is he or she board certified? A board certified plastic surgeon will often be more expensive.
2. How long it takes to perform the procedure. Generally the faster your surgeon, the less facility and anesthesia fees and the greater the surgeon’s profit. Therefore, surgeons have an incentive to work more quickly. When it comes to surgery, faster is not better. Be sure to ask your surgeon how long the procedure will take and be wary if it seems too quick. The average time for a c-section revision is: 1-1.5hrs.
3. The anesthesia provider. There are many types of anesthesia providers. An anesthesiologist who is a medical doctor will be more expensive than a nurse anesthetist. Do your research and find out who provides anesthesia for your plastic surgeon. Dr Rahban is partial to using an anesthesiologist as opposed to a nurse anesthetist.
4. The facility in which your operation is performed. Unfortunately, surgery centers and hospitals are not all created equal. The more sophisticated the facility, the more expensive its hourly fee. Facilities that are Medicare-certified tend to be more costly as well.

Questions to ask your surgeon

Below are specific questions to ask your surgeon during your consultation. Each of these will allow you to understand his or her approach and thus make an informed decision. To print these questions so you can ask your surgeon, see link below to download a copy. Then schedule a consultation for arguably the best C-section scar removal Beverly Hills has to offer.

Download questions