Abdominoplasty : Lower abdominal sagging after cesarean section and abdominal liposuction
Hello, this is Dr. Kukhan Lee.
During childbirth, a cesarean section is sometimes unavoidable.
However, beyond the scar itself,
it often leads to changes in the body line,
which can become a source of concern for many patients.
Skin sagging and step-off around the cesarean section scar
For those who clearly remember
their body shape before surgery,
these changes can feel
more stressful than expected.
Weight gain during pregnancy and childbirth,
loosened skin,
and stubborn lower abdominal fat
that does not easily disappear after delivery
are common concerns.
In addition, the step-off that forms
above and below a cesarean section scar
often becomes a source of discomfort,
with many patients mentioning it
whenever they choose clothing.
In this article,
we will introduce a case
in which the step-off around a cesarean scar
and lower abdominal sagging
were corrected through abdominoplasty.
Cesarean section scar and step-off abdominoplasty consultation
The patient was 164 cm tall and weighed 60 kg,
and had delivered two children by cesarean section.
During pregnancy, her weight had increased
to as much as 95 kg in the past.
Several years ago, she underwent
abdominal liposuction over the entire abdomen.
However, the step-off around the scar
and lower abdominal sagging
could not be improved with liposuction alone,
so she visited us seeking additional correction.
Preoperative abdominoplasty consultation – Lesarts, Dr. Kukhan Lee
During the physical examination at consultation,
general skin laxity of both the upper and lower abdomen
and rectus diastasis were observed.
Lower abdominal sagging was particularly prominent,
and the cesarean section scar was positioned relatively high,
making the step-off around the scar
clearly visible.
As a result, sagging skin above the scar
overlapped and accumulated,
creating a noticeable step-off deformity.
Considering the upper abdominal laxity
and rectus diastasis together,
an M-type full abdominoplasty
would have been more appropriate.
However, the patient did not feel
significant discomfort in the upper abdomen
and wished to correct only the lower abdomen.
After a thorough explanation,
we planned a mini abdominoplasty
focused on the lower abdomen.
That said, even with a mini abdominoplasty,
if the amount of skin laxity is significant,
it may be difficult to substantially shorten
the incision length.
In this case as well,
although a mini abdominoplasty was performed
with the goal of lower abdominal correction,
we clearly explained in advance
that the incision length could be similar
to that of an M-type abdominoplasty
before proceeding with surgery.
Revision abdominoplasty results – Lesarts Plastic Surgery – Dr. Kukhan Lee
These photos were taken eight months after abdominoplasty.
The incision was placed lower
than the previous cesarean section scar,
and the step-off that had formed
around the scar was corrected
in a relatively clean and refined manner.
Lesarts – Abdominoplasty after cesarean delivery, before-and-after comparison – Dr. Kukhan Lee
In addition, adhesions formed from prior liposuction
were thoroughly released,
and the skin was pulled downward and repositioned.
As a result, surface irregularities of the lower abdomen were reduced,
allowing for a smoother and more refined abdominal contour.
Lesarts Plastic Surgery – Abdominoplasty results
(Cesarean scar and step-off correction) – Dr. Kukhan Lee
However, because the procedure focused only on the lower abdomen,
some skin laxity in the upper abdomen remains,
which should be considered a limitation of this approach.
For this reason, setting realistic expectations
through thorough preoperative consultation
is extremely important.
If you are experiencing discomfort not only from the cesarean scar itself,
but also from surrounding skin laxity or step-off deformities,
we recommend seeking a professional consultation
to determine the most appropriate surgical approach
based on your individual body type and condition.
![[Abdominoplasty]Why does a tummy tuck inevitably leave a long scar?](https://lesartsps.com/wp-content/uploads/2025/12/251204_abdominoplasty_post_01.jpg)
