Surgery After Pregnancy

Pregnancy and motherhood are wonderful and exciting times in a woman's life. Some women however, will experience unwanted permanent physical changes that are not always desirable. Many women find it emotionally and physically difficult to adjust to these new changes in their bodies. Often their self-esteem and personal self-image is affected. These changes vary greatly and can be as limited as stretch marks and varicose veins, or the changes can be more significant such as smaller breasts and larger hips.

Fortunately, there are many treatments available to correct or improve these common post-pregnancy changes. Many of these procedures are non-surgical or relatively simple outpatient surgeries. Some treatments are possible because of new technology such as lasers and liposuction developed in just the last few years.

Procedures

Breast changes vary widely from patient to patient. There are many health and nurturing benefits of breast feeding, but these changes occur regardless of whether or not a woman chooses to breast feed. Changes in a womans breasts after delivery should not influence her decision to breast feed. The majority of changes will occur during the pregnancy itself. After childbirth, when the mother is no longer lactating, the breast glands will shrink. Most often this leaves the breasts smaller and possibly with excess loose skin which causes the breasts to sag.

Breast enlargement (augmentation) with an implant may improve the size and shape of breasts. This will also help to fill the excess skin. If there is too much loose skin and sagging then a breast lift (mastopexy) is required. This procedure essentially removes excess skin to tighten and lift the remaining skin and breast tissues. The incisions vary depending upon the amount of skin to be removed. Some women benefit from a combination of these two procedures called am "augmentation-mastopexy."

Breast "hypertrophy" or permanent enlargement may occur on occasion following pregnancy. If this change is unwanted and physically or emotionally uncomfortable, it can be corrected surgically by breast reduction. This operation is similar to a breast lift, however in addition to removing skin, excess breast tissue is also reduced. This creates smaller, firmer and more youthful looking breasts.

Abdominoplasty or "tummy tuck" is an operation which can tighten the abdominal muscles, remove localized excess fat and tighten the skin. Following pregnancy a woman can experience any of these conditions alone or in combination. For example, your weight and body fat may be low yet stretched, weak abdominal muscles may result in laxity and forward protrusion of the lower or entire abdomen. If the muscles are actually separated, this weakness is a type of hernia or "diastasis recti". Some insurance plans will authorize payment for a portion of this operation if it is causing functional medical problems such as pain and discomfort. Tummy tucks (abdominoplasties) can therefore be fairly simple "mini-tuck" or a more extensive standard Abdominoplasty - which corrects all the conditions noted above.

Umbilicoplasty or improving the belly button is an additional benefit of the tummy tuck as is removal of stretch marks of the lower abdomen. This can actually be done as a separate minor procedure if the belly button has been stretched or distorted by the pregnancy.

Stretch marks which occur during pregnancy can be improved in a variety of ways through various techniques. A tummy tuck may surgically remove many of the skin changes. Topical treatments which have shown some benefit include laser therapy and some medications such as Retin-A. Lasers may diminish redness for some patients and possibly improve the texture of the skin.

Liposuction is the most commonly requested cosmetic surgery procedure. New mothers sometimes experience redistribution of their body fat. Localized fat collections in the tummy, hips, thighs, and upper arms to name a few of the more common areas, are treated easily and with excellent results, with either standard or the newer ultrasonic liposuction. When combined with a sensible diet and exercise program you can successfully work toward regaining your pre-pregnancy body contours and clothing size.

Labioplasty and vaginal tightening or myoplasty are outpatient operations to repair tears or damage to the labia (opening to the vagina) and vagina which may occur during a normal vaginal delivery.

Skin pigment changes (chlosma), can occur during pregnancy. Irregular red or brown discoloration across the face is very common side effect of pregnancy. This is generally improved with a bleaching or peeling program by our skin aesthetician. More difficult cases are referred to a dermatologist.

Varicose veins and spider-veins frequently appear with the hormonal and body fluid changes during pregnancy. While varicose veins generally occur on the legs, "spiders' may arise on any part of the body. Treatment may be as simple as the newest lasers recently developed for these specific problems Sclerotherapy or injections of varicosities is often successful. Lastly, outpatient surgery to remove portions of the larger varicose veins can be performed through tiny "nicks" in the skin with minimal visible scars.

Combined operations are often performed with our Gyneacology colleagues. Tubal ligation is a common post pregnancy procedure which is done at the time of many of the surgeries noted above. If you require a gyneacologic operation or study (laparoscopy) and are considering a plastic surgery procedure, discuss these issues with your doctor. Combining these procedures decreases anesthetics, costs, and recovery time.