pregnancy

Caesarean scar

Generality

The caesarean section scar is a sign that results from the surgical incision of the abdomen and uterus wall, which has as its purpose the extraction of the child from the womb. This cut can extend in a transverse or longitudinal direction.

For many women, the caesarean scar is a more or less obvious imperfection with which to live; other times, on the other hand, it is associated with complications (such as keloids, hernias or adhesions) that make the presence particularly annoying.

Although it may be difficult, just for the moment when the new mother is living, it is important to pay attention to the caesarean scar. From the outset, the surgical wound resulting from the operation must be medicated and treated with care, according to the doctor's instructions. Once the scar is formed, it is advisable to apply specific products (silicone-based devices, drugs or cosmetics), suitable for improving their appearance and favoring their flattening over time .

However, if these strategies are not enough, it is possible to use the option of plastic surgery or aesthetics more appropriate to one's case.

What's this

The caesarean scar is the result of a birth not brought to a conclusion by the "traditional" vaginal way. In certain circumstances, in fact, a surgical incision is practiced by the doctors to facilitate the birth of the child . This cut extends approximately 8-15 cm, in a longitudinal direction (that is, in correspondence with the central line of the abdomen, starting from the pelvis) or transversal (above the pubis).

After a few weeks, the surgical wound regresses naturally. Over time, if managed with due care, the caesarean scar becomes a thin, almost imperceptible sign. Other times, what remains of the cut may evolve into a keloid or give rise to other problems.

Cesarean section: key points

  • Caesarean section is a surgical operation during which a child is born through an incision made in the wall of both the abdomen and the uterus of the pregnant woman. This option is chosen only when it is considered safer for the future mother or the fetus, compared to the natural birth through the vagina. The operation is performed after the administration of anesthesia which may be spinal, epidural or general.
  • The caesarean section can be elective (ie programmed at the end of gestation, before labor) or adopted in an emergency regime (when the health of the mother and child are in immediate danger).

Causes

Like any surgical procedure, caesarean section leaves a more or less visible scar on the skin.

Immediately after the operation, the wound resulting from the incision made at the abdominal level has a reddish or pinkish color. Over time, the pigmentation of the scar tends to darken, taking on a shade ranging from purple to brown, depending on one's complexion.

After about a year, the scar tends to lighten up to a light or brown hue, becoming more and more similar to skin tones.

Several factors can affect the cesarean section healing process .

First of all, it must be considered that, after giving birth, two very different pieces of tissue are stitched together: the pubic, constitutionally thicker and fatty, and the abdominal one, usually very thin precisely because of pregnancy. This can predispose to the formation of "step" or hypertrophic scars (keloids).

Keloid scar: why is it formed?

Caesarean keloid is formed due to excessive proliferation of fibroblasts and an increase in collagen production. These abnormalities in the healing process result in a voluminous scar, more extensive than the initial wound, only a few weeks after birth. From soft and reddened, this sign can thicken over time and become hypertrophic, until it becomes thick and hard.

Did you know that…

The quality of the scars is influenced by genetics. For this reason, some people are constitutionally predisposed to develop obvious signs, even when all the precautions are taken to favor their correct recovery.

Symptoms and Complications

The caesarean scar can affect the new mother in a different way: some surgical wounds remain almost invisible with the passage of time, others are evident or cause a deformation of the abdomen, in terms of thickening or sinking.

After cesarean delivery, the stitches favor the closure of the surgical wound, which closes in 7-10 days. Instead, tissue consolidation requires a few months.

Caesarean scar: associated disorders

  • Isthmocele : this is an internal hernia of uterine tissue that forms after cesarean delivery. More precisely, a sort of pouch is created in the area of ​​the uterine wall (between the cervical canal and the internal uterine orifice) which is incised to extract the child and then sutured. The istmocele can cause various disorders, such as pain and atypical blood loss, up to infertility.
  • Adherences : they appear as fibrosities below the caesarean scar, which connect two parts that should not be joined. In this case, the muscular planes and lower abdominal organs do not flow properly, causing a malfunction of the part and severe pain.
  • Scar infection : manifested by hypersensitivity of the part, red and very swollen edges, bleeding or pus and high fever. Should this occur, it is advisable to call the doctor immediately.

Diagnosis

The evaluation of the caesarean section is the responsibility of the dermatologist, who can recommend the most appropriate strategies to minimize it and promote a good healing process. In fact, there are several options for the management of the problem, but it is important to carefully examine the characteristics of the lesion and of the skin, to identify the most suitable treatment for your case.

To remember

The healing process varies from person to person and may also depend on the type of skin.

Cures and Remedies

The caesarean scar requires some care after birth to help the tissues regenerate in the best way. These measures serve to prevent the healing cut from becoming hypertrophic, becoming even more evident.

The solutions available to make the scar from cesarean section gradually disappear are many and may include, for example, a few minutes of massage a day, topical use of cosmetics suitable to improve their appearance, moisturizing products and compression with silicone-based devices. In the puerperium, these devices help the tissues to heal better and minimize the outcome of the intervention in question. However, if these strategies are not enough to resolve this problem in a definitive way, it is possible to resort to surgery .

Immediately after cesarean delivery

After a caesarean section, some precautions are necessary to facilitate wound healing .

At the end of the operation, the surgeon sutures the incision made in the uterus and in the abdominal wall with wire or metal staples, which will be removed in the following 7-10 days. In the area where the cut was made, the appearance of pain, tingling or burning is possible, especially when changing position or getting out of bed; in this case, it is possible to take an analgesic, after consulting the doctor. These symptoms should decrease in intensity within a week or two.

Immediately, the cut must be medicated and treated with care according to the doctor's instructions : the caesarean section wound must remain covered and disinfected, until complete recovery. During convalescence, care must be taken to avoid rubbing the clothes, so as not to tear the stitches.

When it is healed, the scar can be cleaned with water and neutral soap, buffered with sterile gauze (without rubbing) and left to air dry for a few minutes.

Massage

Once the scar is formed, then the wound is healed and no longer causes pain, it is advisable to massage it with gentle movements and specific products. This daily habit can favor the flattening of the lesion, as well as improving its appearance over time. The ideal is to perform the massage in a supine position, for at least 20 minutes. You can alternate circular movements with the fingertips (both above the scar and around it) to slight percussion, remembering that the massage should never be painful.

Gel and silicone patches

A simple method to effectively minimize the caesarean scar involves the use of a plaster or silicone foil . This device should be applied regularly every night, after the birth, on the cutting area, until the scar disappears.

The silicone patch has been designed to limit the hypertrophy of the scar, that is its expansion, avoiding that it remains too fibrous and thick.

During the day, the effect of the silicone patch should be supported by the application of a silicone-based or heparin-based gel, which favors the minimization or even the disappearance of the scar.

Cosmetics and natural remedies

The cesarean scar can be tackled with topical products formulated with ingredients with high regenerative properties against skin tissue.

There are natural creams, gels and extracts (such as musk rose, aloe vera, borage, marigold and lavender) that reduce inflammation, stimulate skin regeneration and present natural antiseptic properties. These products also contribute to reducing the thickness and pigmentation of the caesarean scar.

Caesarean scar: eliminate it with surgery

The use of surgery can be indicated when the caesarean scar is aesthetically unpleasant or causes an evident deformation of the abdomen, as in the case of the so-called "apron belly" (ie a sort of step is formed) or of the formation of particularly severe keloids .

Available options include:

  • Microsurgical lifting : the skin shrinks and resumes tonicity, "cutting out" the old caesarean scar and replacing it with a little visible sign;
  • Abdominoplasty : allows you to remove the flap of soft and wrinkled skin, while eliminating part of the excess subcutaneous fat and stretch marks from pregnancy. Therefore, the operation minimizes the caesarean scar and reshapes the abdomen.

Other therapeutic options

To gradually clear the scar of the caesarean section, specific treatments can also be evaluated, such as laser therapy or lipofilling, to be performed at qualified medical centers. These solutions make the fabrics more "vital", activating their natural regeneration. After a few sessions, it is possible to observe, consequently, the aesthetic improvement of the caesarean scar.

Other interventions available are pressure therapy, cryotherapy, intralesional drug injections and radiotherapy .

Some advice

  • Relying on the advice of your primary care physician or your dermatologist is certainly an excellent strategy for dealing with the caesarean scar in the most correct way;
  • Keep the scar area hydrated to promote the natural regeneration of the skin (this also helps to minimize the pain caused by body movements and strains);
  • Protect the cesarean scar from the sun, to avoid hyper-pigmentation phenomena;
  • Adopting a healthy and balanced diet, rich in fruit and vegetables, is essential to nourish the skin and ensure the elements necessary to promote its normal functions, including tissue regeneration.