10/14/2026
What Is a Micro-Brazilian Cesarean Incision?
Developed by Dr. Julio Cesar Novoa, MD — Cosmetic OB/GYN Surgeon, 2017
The Micro-Brazilian Cesarean Incision (MBI) is a term coined by cosmetic obstetrician-gynecologist Dr. Julio Cesar Novoa, MD, in 2017 to describe a modification of the traditional Pfannenstiel incision used during Cesarean section delivery.
The technique was developed with the goal of combining the surgical requirements of Cesarean delivery with an improved cosmetic appearance of the lower abdomen.
1. A Lower, More Concealed Incision
Unlike the traditional Pfannenstiel incision, which may remain visible when wearing revealing clothing, particularly a bikini, the Micro-Brazilian Incision is positioned lower, within the region of the mons p***s.
The objective is to conceal the resulting Cesarean scar beneath the fabric of a Brazilian-style thong bikini, minimizing its visibility.
This approach emphasizes that the cosmetic appearance of a Cesarean incision should be considered alongside the obstetric and surgical requirements of the delivery.
2. Reducing Scar Adhesions and Tethering
An additional objective of the Micro-Brazilian technique is to minimize unfavorable scar formation associated with adhesions between the skin, subcutaneous tissues, and underlying re**us fascia.
Traditional Pfannenstiel incisions are sometimes placed within or near the suprapubic crease. In certain patients, healing in this region may result in scar tethering, particularly when the subcutaneous tissue layers are not adequately reconstructed.
Dr. Novoa's approach emphasizes careful restoration of the subcutaneous anatomy, including appropriate management of Scarpa's fascia, to reduce the potential for scar adherence to deeper tissues.
Scar tethering may contribute to:
- Reduced mobility of the skin and scar.
- Persistent localized discomfort or pain.
- An indented or depressed Cesarean scar.
- Increased prominence of the overlying suprapubic skin fold, commonly described as the Cesarean apron.
Although anatomically plausible, the degree to which this particular incision and closure technique reduces these complications compared with conventional Pfannenstiel incisions has not been established through comparative clinical studies.
3. Cosmetic Objectives
The Micro-Brazilian Cesarean Incision is designed to achieve several cosmetic goals:
- Lower scar placement: Positioning the incision within the mons p***s when anatomically and surgically appropriate.
- Improved concealment: Allowing the healed incision to remain less visible beneath bikini-style clothing.
- Improved scar mobility: Minimizing adhesions between the superficial and deeper abdominal tissues.
- Reduced scar indentation: Supporting a smoother transition between the lower abdominal skin and mons p***s.
- Improved abdominal contour: Reducing unfavorable scar tethering that may accentuate the Cesarean apron.
4. The Importance of Surgical Technique
The cosmetic outcome of a Cesarean section depends on more than the location of the skin incision.
Attention to tissue handling, hemostasis, appropriate anatomical closure, wound tension, and postoperative healing is essential.
The Micro-Brazilian approach emphasizes preservation and reconstruction of the relevant abdominal wall and subcutaneous tissue planes, including Scarpa's fascia, when appropriate.
The incision location must also permit safe access for delivery. A lower skin incision does not necessarily change the location or type of uterine incision.
Conclusion
The Micro-Brazilian Cesarean Incision represents Dr. Novoa's cosmetic modification of the traditional Pfannenstiel approach, with an emphasis on lower scar placement, bikini-line concealment, and meticulous anatomical closure.
Its guiding principle is simple:
“If you have to have a Cesarean section, shouldn't it have a cosmetic appearance as well?”
Clinical note: The Micro-Brazilian Incision is a surgeon-defined technique rather than a separately standardized incision category. Claims of reduced pain, adhesions, Cesarean apron formation, or equivalent safety require comparative clinical evidence. Individual results depend on anatomy, surgical circumstances, and healing.
