So you’ve had your babies and now want a mummy makeover to get your body back. Dr Terrence Scamp, Specialist Plastic Surgeon and member of the Australasian Society of Aesthetic Plastic Surgeons explains why you need to be kind to yourself and what help is available to you when the time is right.
For many women childbearing can take a heavy toll on the body. From the enlargement then shrinkage of breasts, stretching of skin leaving marks and a loss of elasticity, to varicose veins and abdominal walls that have been severely damaged. It really is remarkable what the female body goes through to bring life into the world.
If you’re one of the lucky ones with good skin elasticity, the right baby to body weight ratio, and not too many pregnancies, then you may be able to get yourself back into shape. A little liposuction to the abdomen and flank region may complete the picture.
However, liposuction in the absence of good skin tone can result in significant contour irregularities, leaving bumpy and uneven abdominal skin. That’s why it’s best to seek out the services of a Specialist Plastic Surgeon who is appropriately trained to ensure the result you get is optimal.
Liposuction may be used in conjunction with a tummy tuck to contour the love handle region or to further shape the abdomen for a more pleasing result. Technical advances in this procedure have helped to make it safer, more effective, and the results more aesthetically appealing.
A tummy tuck is like having a suit made. Your abdominal skin and muscle sheath are being shaped to fit you. The slimmer and trimmer you are the more the “cloth” can be cut to fit you and the better you will look.
Whilst it seems plausible to have the surgery done as soon as the baby is out, the safest and most effective time is once your body has had time to heal and you are back to your pre-pregnancy weight.
Even if you rapidly return to your normal weight range the powerful hormones of pregnancy and breastfeeding take quite some months to “wash out” of your body. For most women it takes about 12 months after pregnancy for your body to recover. You need to give your skin and muscles time to spontaneously shrink back to their previous proportions. Therefore any surgery, such as a tummy tuck, is best left until these natural recovery changes have occurred.
It may be a major chore when you are sleep deprived to prioritise exercising. However, it will help to restore your muscle tone, even getting out of the house and pushing the pram for 30 minutes can make a big difference to how quickly you drop off the baby kilos. What it can’t do unfortunately is fix any excessively loose skin that may have resulted from pregnancy. If there is skin excess, it generally needs to be removed, and the greater the excess, the more the excision and unfortunately scar is required.
If the skin excess is mild, limited skin excision even via a caesarean scar may be enough to improve the tone. This can be combined with liposuction and tightening of the lower muscle sheath if that has been stretched with pregnancy. This is called mini-abdominoplasty, a variable combination of skin tightening, muscle wall repair and liposuction, as determined by the problems resulting from pregnancy.
If skin excess is remarkable then a full abdominoplasty (tummy tuck) is usually required. The length of the scar is usually determined by the amount of skin that needs to be removed. Doing liposuction on skin that has poor tone will almost certainly result in contour irregularity and do little to improve the appearance there, so that excess skin really needs to go.
The upside of the tummy tuck is that most stretch marks occur in the lower zone of the abdominal skin and that is removed by this procedure. The upper abdominal skin which is usually less ravaged by pregnancy is then stretched out to cover a larger part of the torso with smooth healthy skin. The repair to the muscle sheath helps greatly to contour the torso and you may find that your backache gets better too as the “pillars of support” at the front of the trunk help take the strain off the backbone.
The longer scar of the tummy tuck procedure allows mobilisation of the skin all the way up to the lower border of the rib cage and the full repair of the stretched muscle wall can be performed. This has the nice effect of restoring the hourglass shape to the waistline. Liposuction to the flank region can help to accentuate that shape and can usually be done at the same time as abdominoplasty. Skin excision is designed in such a way as to place the scar as low as possible so it is easily hidden in most forms of clothing. The other scar is around the borders of the belly button which remains attached to the muscle wall and brought out through a new opening in the mobilised skin.
Contouring surgery to the abdomen is commonly combined with other enhancements, most frequently breast surgery as the breasts also bear the brunt of pregnancy and obviously breast feeding can further change the size and shape drastically.
Some of these procedures can be performed as a day patient under a general anaesthetic. The more extensive muscle wall repairs and skin excisions usually entail a hospital stay and absences from working duties for up to two weeks. Which is why again, it’s important to not rush into surgery when you have a new baby who is largely dependent on you.
So like many fields of medicine, prevention is better than cure. Take your Obstetrician’s advice about appropriate weight gain during pregnancy and don’t regard it as a time to say yes to all those tasty treats that you usually deny yourself. Try also to get back to your normal weight as soon as you can after pregnancy and make time for exercise that helps restore your muscle tone, even as a busy mother with a new baby.