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How to treat your patient’s C-section scar

The scar left after delivering a baby by Caesarian section, whether elective or emergency, can come with a host of physical and mental impacts.

“Everybody heals differently and the body doesn’t always heal as it should. Poor wound healing can happen because of genetics or an underlying medical condition,” says Rachel Myers, senior aesthetician at 111 Harley St, London. “For example, diabetes or obesity can affect wound healing. This can lead to uneven healing or cause the incision to separate and open instead of joining together.”

The location of caesarean scars is also problematic, as finding something to wear – even underwear – while the scar is still healing can be really tough as friction from clothing may result in inflammation.

Says France-based LPG expert and physiotherapist, Natalie Paradis. “C-section patients may develop a keloid or hypertrophic scar. Often the problem with C-section scars is adherence, as C-section surgery cuts right through the dermis, hypodermis and muscles. After stitches, everything can become glued together, causing tugging and pulling. This is adherence and it can cause a lot of pain. Adherence can even move to the organs.”

The fibrosis, scar and C-section procedure itself can also really impact the body’s circulation and lymphatic system causing bloating, swelling, weight gain, cellulite and fluid retention, not just in the stomach but in the legs and other areas too.

“Due to the build-up of scar tissue sticking to muscles or organs, some women experience symptoms related to their C-section scar long after the operation and can feel pain, restriction, or a pulling sensation on or around their scar months or even years after surgery,” says Myers.

A C-section pouch or ‘pooch’ refers to the extra skin or fat that gathers at the bikini incision line after a C-section and tends to be resistant to diet and exercise, which can be very frustrating.

Experts recommend the use of silicone gel patches as a starting point. Then, Paradis says, undoing the adherence of the Caesarean scar is important to free the mobility of the joints, organs and skin.

Self-massage is often recommended to mothers after a C-section scar is well on the way to healing. This may disrupt the fibrotic tissue and increase the pliability of the scar.

Mechanical lipo-massage or endomassage technology harnessed by devices that use motorised rollers can grip and knead the skin to perform a massage deep in the tissue. This helps to stimulate circulation and collagen production and reduce adipose tissue. It targets the connective tissues, including skin, muscle, blood and lymphatic circulation, working to reactivate stagnant cellular activity below the skin’s surface and improve the appearance of scarring.

“Scars and stretch marks created in the last six months respond well to laser treatments and especially well to microneedling and radiofrequency,” says Myers.

Laser scar therapy is another option. Ablative laser resurfacing has been proven to effectively treat scars and provide consistent and significant functional improvement, as well as measurable cosmetic benefits. Fractional skin resurfacing is also proven to be effective on some surgical scarring and can effectively treat textural and pigment concerns.

Cryotherapy for C-section scars may help to tighten the area, which will both lift the skin around the scar as well as help to improve the appearance of the scar itself.