22 Jun Surgery Post-Pregnancy!
BY Dr Terrence Scamp
Who are the body snatchers? Simple. Children. Take a trim taut and terrific girl in her 20’s, laden her with 2 or 3 pregnancies in rapid fire and see the damage that is wrought.
But not all suffer equally. The tall girls seem to “carry it better” but if you combine a petite 50 kgs girl with a 110 kg husband then you have the recipe for maximum devastation.
The abdomen is the obvious one. Pregnancy adds weight in most places but the abdominal wall has to cope with the growing uterus and the only way it can go is out. The muscle sheath of the abdominal wall may stretch to the point where there is a permanent “hole” left after pregnancy or just a generalized laxity. Abdominal skin is stretched until in some cases the deeper layer of the skin tears, leaving what we call stretch marks. The extra skin so necessary to cover this expanding tummy can then become a crinkled ball without the elasticity to spring back into shape.
With careful advice from your obstetrician and one eye on the scales, you can limit the damage by limiting weight gain. Try to keep your exercise programme going as long and as well as you can, and resume it soon after pregnancy when possible.
Weight gain is obviously inevitable during pregnancy and sometimes it’s very hard to shift it from certain spots such as the flanks and lower abdomen.
Where the skin recovers reasonably well options may include simple liposuction or a “mini-tuck”, a combination of liposuction, excision of some skin even just via a caesarean scar and repair of the lower abdominal wall where necessary. Liposuction to the flanks can also be of great benefit by tapering the torso and returning the waistline to its previous dimensions.
However when there is an abundance of excess skin and lots of stretch marks there is no alternative but to excise this skin. This is the full abdominoplasty which comprises the longer lower abdominal scar, repair of the stretched muscle sheath and excision of all the spare skin and associated fat from the belly button to the pubic hairline.
This procedure is more involved and takes more time to recover. Hospitalization for a couple of nights is the norm and recovery is in terms of weeks rather than just days as with liposuction. However it is possible to dramatically recontour the abdomen with this procedure and the scar is kept as low as possible.
For some women, breast changes in pregnancy are relatively moderate and a dramatic loss of shape is not seen, although there is some laxity of the skin, the odd stretch mark and a little bit of emptiness in the upper pole.
However some breasts are enormously stimulated by hormones during pregnancy, increase in size to a vast amount and by the second or third pregnancy the damage has been done. It may be a simple loss of size and augmentation with an appropriate implant can achieve a very pleasing return to shape. The anatomically-shaped or “tear drop” implants are particularly adept at filling the upper pole of the breast and these can help mask some of that “settling” that you can see from pregnancy.
If significant sag has occurred however a breast repositioning or Mastopexy procedure may be required. This entails a more extensive scar and may need to be combined with an implant to correct both loss of size and breast sag.
These breast procedures can be performed as day patients under general anaesthesia, but are not infrequently combined with the abdominal surgery meaning that only one recovery time is undergone.
Your surgeon will be trying to shape your abdomen and breasts to suit you for the long term so try to get yourself “back in shape” prior to undertaking surgery. This will make the surgery safer and more precise. Who would buy an expensive suit and then drop 10 kilograms? Well if the skin of your abdomen and breasts is being shaped to fit you, you want to make sure it’s the “you” that you are going to be for years to come. So get the exercise programme going, get your diet back on line and then get some good advice.
It IS possible to snatch your body back!