First, as a dr, the scar looks like keloids from a lower transverse c-section. This is a common consequence after any incision of darker skin. I would further consider the possibility of an infection. An infection can lead to less than ideal closure, scarring, and the poor cosmetics we see. No one can say if this is a result of a poor quality surgery or the after care by the patient who also has a part to play? Have a c-section do not follow-up (choice or otherwise) and this is what we get?