In the United States, about one in three live births is delivered by cesarean section, better known as C-section. Once a woman has had her first C-section, there is a high probability any future children will also be delivered by c-section, leading to noticeable scars.
In this article, Dr. Joel Aronowitz will describe the different kinds of incisions that are used for C-sections, what to do immediately after giving birth by C-section, and what can be done later about scars that are unattractive or problematic.
The Different Kinds Of Incisions Used For C-Sections
There are three places where the OB-GYN will do the incision for a C-section. One is in the pubic mound, about midway through the mound. The second site for a C-section is at the topic of the pubic hair line, and the third is going up and down vertically instead of horizontally.
The most common site for a C-section is just above the pubic hair line. Ideally, the OB-GYN will cut through the scar from the first C-section to deliver a second, third, or later child through another C-section.
It’s not unusual for a horizontal C-section scar to form a panis, something commonly known as a pooch, a kind of overhang. That happens because the bottom side of a horizontal C-section incision will heal down to the muscle, but the top side of the incision will heal only through the skin.
What Women Can Do To Prevent A C-Section Scar
Joel Aronowitz MD advises women who know in advance that they will have a C-section to have a conversation with their OB-GYN about who will do the closure after the procedure. Mothers-to-be need to ask the doctor who will be doing the closure after their C-section, whether it will be the doctor or some assistant on their team. It is important to communicate to the delivery room physician that you are concerned about how the scar will look.
The incision for a C-section can be closed with staples instead of sutures. Dr. Aronowitz says that sutures are preferable, but staples are OK if they are removed in seven to 10 days. Once the staples or sutures have been removed, apply a silicone cream twice a day for three to six months to keep redness to a minimum.
Dr. Aronowitz says that it is very important to keep the C-section incision moisturized while it is healing. Products without perfumes like CeraVe and Cetaphil often work well, but it is important to test for allergies by using a dot of product on the skin before spreading a large amount of it over the scar.
It’s not impossible to have a C-section scar without having the C-section. This very unusual condition is caused by hyperkeratosis, overgrowth of the skin, and can be prevented with the application of prescription steroid skin creams.
See Your Plastic Surgeon About Problem Scars
If the scar is getting thick or getting raised, Dr. Aronowitz advises patients to come in sooner rather than later to discuss their options for reducing the scar.