In short
- The caesarean scar is excised as part of the procedure: it is not added to the new one, it is replaced by it.
- The new one is transverse, low and longer than the caesarean scar, so that tension is spread without leaving folds at the ends.
- If the operation was a full tummy tuck, there is also a small scar around the navel because it has been repositioned.
- 🔑 Treatment starts at one month, not when the scar “looks bad”. That is where the evidence places the effect: beyond three months, starting was no different from not treating at all.
- ⚠️ Between the first and the sixth month the appearance gets worse, because of the redness and the pigmentation the treatment itself produces. The benefit shows from then on.
- Strict sun protection is part of the treatment, not an added piece of advice.
- No scar disappears. What we are after is one that is flat, fine, the colour of the skin and sitting where it cannot be seen.
The caesarean scar disappears because it is excised: it lies within the skin that is removed. What remains is a new scar, transverse and low, placed where underwear covers it — and usually longer than the previous one, because removing skin means spreading the tension across the width.
What decides how that scar evolves is not only the technique: it is when treatment starts. And there is one figure that changes behaviour: in a meta-analysis of fourteen trials, starting laser treatment beyond three months was no different from not treating at all.
This page follows on from the surgical steps described in how the surgery is decided.
How the scar looks
Transverse and low. It is placed on the line that underwear covers, and that position is planned before surgery, standing up, because lying down the skin does not fall the same way.
Longer than the caesarean scar. This is what surprises people most and it has a mechanical explanation: to remove skin, the tension has to be spread along the whole incision. A short scar under a lot of tension produces folds at the ends —known as “dog ears”— and a worse scar.
And in a full tummy tuck, a second one around the navel. As the skin moves, the navel is repositioned, and that leaves a small circular scar. It is also set out on the tummy tuck page, because it is worth knowing beforehand.
⚠️ The old scar is not “added on”: it is excised. It lies within the area of skin that is removed. It is the same reason why repairing the scar is not billed separately when there is a larger procedure.
Why the closure matters
The way the wound is closed shapes both the scar and the complications.
It is closed in layers, including Scarpa’s fascia —the one that is not always sutured at caesarean section, and whose non-closure explains the shelf (Pelosi, 2026)—. This is not a theoretical detail: in abdominal surgery, preserving Scarpa’s fascia is among the measures that independently reduce seroma formation, along with tissue adhesives and progressive tension sutures (Seretis, 2017).
🔑 And seroma matters for the scar, not only as a complication. A collection of fluid under the skin puts the area under tension and hinders healing, so the measures that prevent it also work in favour of the final result.
The treatment timetable
Here is the information that changes what the patient does.
The centre’s protocol is sessions at one, two and three months —CO₂ laser and IPL—, and that timetable is not arbitrary. A meta-analysis of fourteen controlled trials with 492 participants or surgical scars measured the effect of the starting point specifically (Ji, 2025):
| When treatment starts | Outcome |
|---|---|
| At one month or earlier, against no treatment | Significant improvement (MD −1.66; 95% CI −2.31 to −1.01) |
| At one month or earlier, against starting after 3 months | Significant improvement (MD −1.93; 95% CI −2.24 to −1.62) |
| After 3 months, against no treatment | No significant difference (p = 0.37) |
🚨 The third row is the one to take in: waiting until the scar “looks bad” before treating it is waiting until the treatment can no longer be told apart from doing nothing. It is exactly the opposite of what intuition suggests.
The full detail is in the centre’s scar protocol.
How to arrange it. The six sessions —three of CO₂ and three of pulsed light— are in the centre’s shop as the scar treatment protocol package, with the assessment consultation included. It is that assessment that decides whether the timing is right; if it is not, we say so and refund the amount.
What you see month by month
It is worth knowing before starting, because otherwise the first impression is that things are getting worse.
- First few weeks: a reddened, hardened scar, with the area swollen. This is what is expected.
- From month 1 to month 6, with treatment: the laser itself produces transient redness and hyperpigmentation, and that colour dominates the appearance throughout that period. It is the most disconcerting part, because it looks as though things are getting worse. And yet as early as one month the treated scar was significantly more pliable and smoother on the surface than the untreated one in the trial carried out on caesarean scars (Karmisholt, 2017): the remodelling is going on underneath even though the colour masks it.
- From the sixth month on: the colour resolves and the benefit becomes visible. In that same trial, blinded photographic assessment found the treated scars significantly better, and the biopsy showed new collagen and elastic fibres.
- From one year on: the scar carries on fading and flattening, more slowly.
🔑 The sentence that sums the trial up is the most useful on this whole page: remodelling begins at one month, but it stays hidden until the colour changes caused by the treatment itself have resolved. Anyone who does not know this gives up at the second session.
What depends on you
Not much, but what little there is counts:
- Strict sun protection over the scar throughout the first year. It is what most influences whether it ends up pigmented, and it is part of the treatment, not an extra.
- Not smoking. Tobacco is the single factor that worsens healing most.
- Respecting the timescales for exertion. Tension on a young scar widens it. The timescales vary with the technique —a scar repair is not the same as a tummy tuck with plication—, so they are set by your surgeon at the follow-up and not by a general rule. What you can do and when, in recovering with young children at home.
- Attending the sessions when they are due, which the evidence places in the first three months.
⚠️ And what depends on nobody: how a particular skin heals. Some people have a tendency to widened or hypertrophic scars, and that is assessed beforehand but cannot be guaranteed. No technique and no protocol makes a scar disappear.
Book an appointment
You can book your own appointment. Pick the day and time from the free slots in the diary, in a panel that opens right here, without leaving this page.
Frequently asked questions
Will my caesarean scar go?
Yes, it is excised: it lies within the skin that is removed. What remains is the new scar, lower down and placed where underwear covers it.
Why is the new one longer?
Because removing skin means spreading the tension across the width. A short, tight scar produces folds at the ends and heals worse.
When does treatment start?
At one month. This is not a preference: in the available meta-analysis, starting beyond three months was no different from not treating. Waiting until it looks bad is waiting too long.
I have had the first session and it looks worse, is that normal?
Yes, and it is worth knowing beforehand. The treatment itself produces transient redness and pigmentation that dominate the appearance between the first and the sixth month. After that the colour resolves and the benefit becomes visible, which is what happened in the trial carried out on caesarean scars.
How long does it take to look good?
The bulk of the change is seen between six months and a year, and it carries on improving more slowly after that. It is a course measured in months.
Can I sunbathe?
Over the scar, no, during the first year: it is what most influences whether it ends up pigmented. Strict protection is part of the treatment.
And if I am prone to bad scars?
It is assessed before surgery and it shapes the plan, but how a particular skin heals cannot be guaranteed. It is one of the reasons the protocol starts early: the scar is worked on while it is still forming.
Sources
- Ji Q, Luo L, Ni J, Pu X, Qiu H, Wu D. Fractional CO₂ laser to treat surgical scars: a systematic review and meta-analysis on optimal timing. Journal of Cosmetic Dermatology. 2025;24(1):e16708. PMID 39780524 — Fourteen controlled trials with 492 participants or surgical scars. Starting at one month or earlier improved the scales against control (MD −1.66) and against starting after 3 months (MD −1.93); starting after 3 months was no different from control (p = 0.37). Most trials support 2-3 sessions or more. It is the basis of the protocol’s timetable. Verified on 29-08-2026.
- Karmisholt KE, Taudorf EH, Wulff CB, Wenande E, Philipsen PA, Haedersdal M. Fractional CO₂ laser treatment of caesarean section scars — a randomized controlled split-scar trial with long term follow-up assessment. Lasers in Surgery and Medicine. 2017;49(2):189-197. PMID 27862066 — Randomised split-scar trial in 12 patients with caesarean scars. At one month, significant improvement in pliability and relief; between 1 and 3 months, transient erythema and hyperpigmentation predominated; at 6 months, significant improvement on blinded photographic assessment and histology showing new collagen and elastic fibres. Verified on 29-08-2026.
- Seretis K, Goulis D, Demiri EC, Lykoudis EG. Prevention of seroma formation following abdominoplasty: a systematic review and meta-analysis. Aesthetic Surgery Journal. 2017;37(3):316-323. PMID 28158391 — Nine studies and 664 patients: seroma in 19.5% of controls against 7.5% with preventive measures. Preserving Scarpa’s fascia is among the measures that reduce it independently. It underpins why closing in layers also works in favour of the scar. Verified on 29-08-2026.
- Pelosi MA 2nd, Pelosi MA 3rd, Romero R. The cesarean apron: description, proposed pathophysiology, classification, and prevention through Scarpa fascia closure at cesarean delivery. American Journal of Obstetrics and Gynecology. 2026;233(6S):S118-S128. PMID 41485815 — Describes the role of Scarpa’s fascia and how fibrosis anchors the scar when it is left unclosed. It is the anatomical reason for closing in layers in the corrective surgery. Verified on 29-08-2026.
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If you are about to have surgery or have just had it, what most influences how the scar turns out is starting to treat it within the first month. It is worth asking before the operation rather than after, because the window in which treatment pays off is short and it opens exactly when the scar still looks bad.
Clinical confirmation by the surgeon
Registration no. 46/4624077
Registration no. 46/4624503
Last reviewed: 6 September 2026. This content is for information only and does not replace an individual assessment by a healthcare professional.
