Caesarean Section and Abdomen

A scar can be aesthetically unpleasing or painful, the pubic area and abdomen may become excessively relaxed. Non-invasive, minimally invasive treatments, and surgery can address the issue.

Non-invasive Treatment


Slightly retracted scar

Surgical Technique

Hyaluronic acid


20 minutes



Postoperative Pain




Outcome of Cesarean Section


Abdominal laxity, retracted scar


Puboplasty +/- abdominoplasty, Laser-assisted +/- lipofilling of the labia majora + laser resurfacing of the skin


60/180 minutes, sedation or general anesthesia, day hospital or inpatient


Poor if common painkillers are used.


Rare (infections, delayed healing)


4 weeks

The Mons Pubis

The Mons Pubis is a fatty structure that inevitably becomes ptotic over time. The greater the overweight, the larger the volume of the Mons Pubis, and its ptosis in the normal aging process. Weight loss processes result in further significant tissue ptosis. The descent of the Mons Pubis affects the tone of the vulvar walls and the labia majora, triggering a process of secondary genital ptosis due to the lack of traction and the weight exerted by the Mons Pubis itself on the labia majora. Lifting the Mons Pubis is performed through a miabdominoplasty or abdominoplasty procedure. The incision should be kept very low and moderately arched on the sides to best lift the labia majora.


The Mons Pubis is a structure located above the vulva and borders the abdominal wall. It consists of adipose tissue that continues inferiorly with the adipose tissue of the labia majora and superiorly with the abdominal adipose tissue. Excessive volume and ptosis of the Mons Pubis contribute to the aging process of the vulvar area, making it inevitably less tight, lifted, and toned.


The procedures vary depending on the degree of adiposity and ptosis.

  1. Superficial liposuction or laser-assisted liposuction.

  2. Low incision puboplasty.

  3. Pubic abdominoplasty.

Superficial liposuction or the more modern laser-assisted liposuction, with the use of CO2 laser fiber, allows for reducing pubic volume without worsening tissue tonicity. This procedure can be performed if the Mons Pubis is excessively adipose but maintains good tonicity characteristics.

Puboplasty involves the removal of a rhomboid-shaped area of skin and subcutaneous tissue, with the placement of a scar in an area where a cesarean section incision is typically made. If necessary, liposuction of excess fat is also performed. The goal is to lift the pubic area and subsequently achieve traction on the vulvar region.

Pubic abdominoplasty is employed when the pubic area is excessively ptotic, and the abdomen is similarly sagging. The incision must be kept extremely low to achieve the best traction result on the vulva.

How the interventions take place: what to expect

Simple puboplasty can be performed under local or local anesthesia with sedation, while pubic abdominoplasty requires general or spinal anesthesia.

Risks and Complications

The risks of liposuction are currently very low and primarily associated with hematomas and seromas. The risks of puboplasty and pubic abdominoplasty include infections, seromas, hematomas, and tissue distress. However, these complications are rare, and if the procedure is performed by competent surgeons, it generally has a low overall complication rate.

Can the abdomen be improved during a cesarean section?

The answer is ambiguous: yes and no. If the lower part of the pregnant woman’s abdomen is not very ptotic, then during the cesarean section, a rhomboid-shaped piece of skin can be removed to tighten the lower abdomen. The lower part of the abdominal fascia can be improved by centrally folding it or placing it with greater intention.

If the abdomen is very protuberant primarily due to the weakening of the fascia, then this procedure proves useless and sometimes harmful. By putting more tension on the lower part and reducing the lower prominence, there is a risk of accentuating the protuberance of the upper part. In these cases, it is much better to wait a few months and proceed with a mini abdominoplasty or a complete abdominoplasty.

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