If you’ve given birth via C-section and noticed your midsection looks different than it used to, you’re not alone. Known as the “C-section shelf”, this bulge that can linger around your C-section scar long after you’ve delivered your baby.
It’s been five years since my own C-section, and I still absolutely notice that my belly area doesn’t look the way it did in my pre-baby life — and I’d be lying if I said that I’ve completely accepted my own C-section shelf. But, I try to tell myself what I would tell anyone else: Bodies change. There’s no “right” body type. And while pregnancy and C-section deliveries are not the only valid reasons for those bodily changes, the reality is, these are some of the most massive transformations a body can undergo.
First, we need to destroy the idea that bodies should “snap back to normal” after giving birth. But we also need to approach this issue with nuance. There’s a really fine line between holding ourselves to unrealistic beauty standards and simply making choices about our own bodies so that we can feel the most comfortable in our own skin.
For some people, those choices might involve doing something to minimize that C-section shelf. Whether that involves lifestyle modifications, like exercise or physical therapy, or something like a tummy tuck, only you can decide what the right choice for your body is.
If that choice involves looking into having a tummy tuck, here’s what you need to know about the procedure.
What is a tummy tuck, and how is it performed?
“A tummy tuck, also known as an abdominoplasty, addresses three primary concerns typically faced by women, especially after pregnancy,” says Usha Rajagopal, M.D., Plastic Surgeon and Medical Director of San Francisco Plastic Surgery and Laser Center.
According to Dr. Rajagopal, the procedure can address excess skin or fatty tissue in the lower abdomen; rectus muscle diastasis (which occurs when the rectus muscles separate due to pregnancy), and stretching of the skin caused by pregnancy.
“Overall, a tummy tuck procedure aims to address these concerns comprehensively, providing a solution for a more contoured and tightened abdominal area,” says the expert.
What makes someone a good candidate for this procedure?
“Ideal candidates are individuals—both women and men—in good overall health,” says Dr. Rajagopal. “ This entails being at a stable weight, not being obese, and having no chronic health issues like hypertension or diabetes.”
“Contraindications primarily include individuals with chronic health problems such as high blood pressure, diabetes, obesity, heart conditions, smokers, or those on blood thinners, [and] patients with a history of blood clotting disorders, like deep vein thrombosis (DVT),” adds Dr. Rajagopal.
What type of results should people expect from a tummy tuck?
“It's essential for patients to have realistic expectations regarding the final aesthetic outcome of the procedure,” says Dr. Rajagopal.
You may have a picture in your head that involves a complete body transformation, but the effects of a tummy tuck aren’t necessarily permanent.
“Gaining weight after a tummy tuck can indeed impact the aesthetic results achieved through the procedure,” Dr. Rajagopal says. “Whether it's a tummy tuck or liposuction, maintaining a stable weight post-surgery is crucial for the long-term effectiveness of body contouring procedures.”
“During a tummy tuck, excess skin is removed, and sometimes, liposuction is performed to refine the contours of the abdomen,” she adds. “However, significant weight gain—beyond just 5 or 10 pounds—can lead to an increase in intra-abdominal fat, also known as visceral fat, which accumulates deep within the abdomen around the organs.”
As we mentioned, bodies change over time — that’s normal. However, after a tummy tuck, that aesthetic change does depend on maintaining a somewhat stable weight.
If someone gains weight around their midsection after a tummy tuck, “The abdomen may no longer appear flat, despite the absence of excess skin,” says Dr. Rajagopal. “Instead, patients may notice a bulging or protruding abdomen, reminiscent of a beer belly, as the intra-abdominal fat pushes against the skin.”
Does a tummy tuck leave a scar?
In short? Yes. The scar will be placed close to where a C-section scar usually appears, but a tummy tuck scar is typically longer — about three times the length of a C-section scar.
“Understanding that abdominoplasty results in a permanent scar—typically a long one across the abdomen—is crucial. While scars generally fade over time, they may vary in visibility based on factors like skin tone. Lighter skin tones tend to have less noticeable scars compared to darker skin tones. Despite the scar's length, it can typically be concealed under clothing, and many women regain the confidence to wear a bikini post-surgery.
What is recovery after a tummy tuck like?
Contrary to popular belief, recovery is significant. According to Dr. Rajagopal, one misconception about tummy tucks is that they’re simple procedures with quick recovery periods.
The reality? This is a major surgery which is typically performed under anesthesia.
“The procedure, which often lasts between three to five hours and may include liposuction, targets the superficial layers of the abdomen. Recovery tends to be longer compared to other surgeries, with a minimum of two days before patients can resume normal activities like driving,” she adds. “Additionally, individuals who have undergone muscle tightening are advised to refrain from activities heavily engaging core muscles, such as sit-ups or planks, for at least six months to a year. Understanding these aspects helps dispel misconceptions and sets realistic expectations for tummy tuck patients.”
Recovery also includes some pain and discomfort, which can be managed via medication, as well as wearing compression garments, and activity restrictions.
Are there risks associated with tummy tucks?
There are risks, and people need to be aware of them when considering the procedure.
“These include the potential for infection, which can typically be managed with antibiotics. Pain and discomfort around the incision sites are common, as is bleeding, which could lead to blood clots. Swelling is also expected post-surgery, as is delayed healing due to poor blood supply in the skin,” says Dr. Rajagopal.
Fluid accumulation, scarring, and tissue damage are other risks.
“These risks should be thoroughly discussed with your surgeon before undergoing the procedure,” says Dr. Rajagopal.
Zara Hanawalt is a freelance journalist and mom of twins. She's written for outlets like Parents, MarieClaire, Elle, Cosmopolitan, Motherly, and many others. In her (admittedly limited!) free time, she enjoys cooking, reading, trying new restaurants, and traveling with her family.