Hate Your C-Section Scar or C-Section Shelf? You're Not Alone.

Let’s get real for a second: welcoming a baby into the world is one of life’s greatest joys — but the aftermath? Not always so joyful. Especially if you’re one of the 1 in 3 women in the U.S. who delivers by C-section. In fact, according to the CDC, nearly 32% of births in the U.S. are Cesarean deliveries. And with that stat comes a whole lot of women complaining of the same thing: a thick, tight, numb scar...or the dreaded C-section shelf.

As a female plastic surgeon specializing in C-section scar revision in Seattle, I see this all the time. To be honest, many of these conversations have been started amongst my own mom friends when social get-togethers inevitably turn into conversations about mom stuff– birth stories, kid complaints, advice and yes, our bodies and how they have changed. As a mom, both of my births were vaginal so I never had to deal with either a c-section recovery or the aftermath scar. As a female Plastic Surgeon, however, I’ve been astonished at how many of my fellow moms hate their scar but have no idea there is any alternative. Well, let me be the one to give you the good news– there is something you can do about it, and it just might be more simple than you think. 

Let’s break it down.

What Is the C-Section Shelf?

The C-section shelf is that overhang of skin and fat above your scar that no amount of crunches seems to fix. It’s not just about “baby weight” or core strength — it’s anatomical. During a C-section, the incision is typically made right at the junction between your thinner groin skin and the thicker lower abdominal wall. If that scar heals tethered (which it often does), it can create a step-off or bulge above the incision. This is especially noticeable when there’s also loose skin, fatty tissue, or muscle separation (diastasis recti) causing a bulge in the lower abdomen.

Common complaints I hear:

• A thick, raised scar

• Numbness or weird nerve sensations

• Tightness when standing or moving

• A persistent bulge or “pooch”

• The dreaded shelf effect in leggings or swimwear

And let’s be honest — it’s not just cosmetic. It affects how you feel in your clothes, in your body, and in your confidence.

The Fix: C-Section Scar Revision

As with everything in Plastic Surgery, there is no one-size-fits-all fix and an individualized, tailored approach always yields the best surgical results. Just like every birth story is different, so is every scar. But here’s a breakdown of what surgical options may be available depending on your unique anatomy and goals:

Scar Revision Only

This is the most straightforward fix. I remove the old, thickened scar and replace it with a thinner, more refined one. Ideal for those without major skin laxity or a shelf. This honestly takes about 30 minutes to perform from start to finish and can be done awake in the office or with some light sedation in the operating room (depending on patient comfort level). 

Liposuction

If you’ve got a step-off or fullness above the scar, targeted liposuction can help smooth out the contour and soften the shelf. It’s not about losing weight — it’s about rebalancing the transition between the upper and lower abdomen.

Skin Excision

Now this can be tricky and how we approach loose skin is based in anatomy with a sprinkle of patient expectation. If you have a tremendous amount of loose skin in both the upper and lower abdomen, sorry but you will likely be best served with a full on tummy tuck. If, however, your skin laxity is concentrated right above the c-section scar then a mini-tummy tuck approach will work best. In some patients, we could go either way– full on tummy tuck versus correction of only the lower abdomen. This is a scenario where goals and expectations come into play— if your goal is to wear and feel good in a bikini then a tummy tuck is likely needed but if your goal is only to make the “shelf” go away in clothes, then a more modest approach can be used. At the end of the day, everyone wants the least amount of surgery for the biggest amount of impact but the most important consideration should be the correct procedure to address your own specific anatomy and plastic surgery goals. 

Combination Approach

Most of my patients benefit from a blend: scar revision + lipo + skin tightening. This combo gives a flatter, smoother contour while dramatically improving the appearance of the scar and shelf.

Abdominal Bulge

Persistent abdominal bulge after childbirth is likely secondary to a rectus diastasis, or separation of your paired ab muscles in the midline. This happens in all pregnancies to make space for the growing baby, but in some women resolves after birth. For those where it doesn’t, the muscles can be repaired at the time of a mini and full tummy tuck but will vary between the two approaches. In a mini tummy tuck or tightening of the skin only around the c-section scar, dissection remains in the lower abdomen only. Thus, muscle repair can only be done in this setting below the belly button. If a standard tummy tuck is utilized for correction, the entire muscle separation both above and below the belly button can be repaired simultaneously.

Why Work with a Female Plastic Surgeon in Seattle?

Let’s be real: having a surgeon who understands what you’ve gone through matters. As a female plastic surgeon, I’ve had countless conversations with moms who felt dismissed, embarrassed, vain, or told to just “accept it.” Even more, almost every day I meet a mom who has spent years believing that if she just ate less or worked out more her abdomen would correct itself. My job is not only to help you restore your body, but it's also to validate your concerns, offer real solutions, and guide you through recovery with compassion and honesty.

Bottom Line: You’ve Got Options

Too many women live with discomfort, frustration, and body image issues post-C-section thinking, “This is just the way it is now.” It doesn’t have to be.

Whether you need a simple scar revision or a full tummy tuck, C-section scar revision is a highly effective way to improve your contour, comfort, and confidence. And no — you don’t have to fly to Miami, gamble on some sketchy TikTok surgeon, or hide behind high-waisted leggings forever.

---

Dr. Megan Dreveskracht is a Seattle-based Female Plastic Surgeon who specializes in Aesthetic Surgeries of the Breast, Body & Face. To schedule your consultation, call 206.860.5582 or fill out a contact form here.