Post Pregnancy Cosmetic Surgery

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You can look as good as you did before you had babies with these surgical procedures. And don’t worry, only your doctor need know...

By Margot Bertelsmann

Do you resent having given your body up for childbearing? Are you sad because no matter how much you diet and exercise, your body still doesn't look the way it did before you had children?

If you answered yes, you are not alone. Worldwide, but also in South Africa, the numbers of women who are turning to surgery to fix the signs of pregnancy and childbirth on their bodies is increasing.

The reasons are varied: women are having fewer children, but later in life. For the past two generations, women have been able to plan for their “pregnancy years” as a phase lasting a few years, unlike our grandmothers, for whom an almost constant state of pregnancy or postpartum throughout their fertile years was more likely.

According to the website, “in 1998, 44% of births were to women over 30. The biggest increase in the birth rate over the last decade is in women aged 35 to 39 – up by 60%. The number of births to women aged between 40 and 44 has doubled over the past decade.”

Why are we waiting to have children? Because we can. Effective birth control and changing social mores have meant that women can focus on obtaining qualifications or establishing a successful career before contemplating motherhood.

If you know you will have one or two children in your late twenties or early thirties, you have a long chunk of your life left over in which you are neither with child or recovering from childbirth. And that, in turn, frees women up to think about what else they might want out of life, in addition to being a caregiver to children. Women might also desire fulfilling, well-paid work, the freedom to pursue interests and ambitions, or to remain physically and sexually attractive and active for as long as they can.

As options for women have opened up, so have desires – specifically, to look as good after they’ve had children as they did before. Impossible? No. Medical science is helping by innovating new procedures exist to help women turn back time and return to their prepregnancy look. Liposuction

Just like some women go up a shoe size after pregnancy, some find that their hips and midriff, especially, never revert to the same shape again, even if she’s returned to her prebaby weight. In that case, why not turn to the miracle of modern technology to help you literally shave those last few centimetres off your butt waist or thighs?

“We all have problem areas that are difficult to fix,” says Dr Craig Shaw. “This is due to our sedentary lifestyle, and the fact that we no longer chase our prey, or run to avoid being prey. Being female, having kids, and doing so at an older age while juggling a career doesn’t help.”

“Then there is the genetic factor, which means that in some women stubborn fat deposits stick in those areas, and budge only after having lost all the fat in the areas it shouldn’t be lost, such as the face and breasts.”

“This is where liposuction/liposculpture is the ideal technique. Using a blunt tube or cannula attached to a strong suction machine, fat cells can be removed from these impossible areas without harming the fascial structures, blood vessels or nerves to the skin. This is most helpful because we have a set number of fat cells, and those that are removed by liposuction are not replaced by the body. Because no skin is removed, and the muscles are not disturbed, there is no effect on future pregnancies.

The most common misconception is that of all the fat cells or fat itself will now accumulate elsewhere on the body. That’s not the case. Fat can accumulate with irresponsible eating habits, but does so in a more balanced and even manner.” And how long until you recover? “The volume of fat removed directly affects recovery time,” says Dr Shaw, “but there is a longer time to full skin shrinkage. If you religiously wear special pressure garments in the early recovery and healing period, you can speed up the process.”

Tummy Tuck

There’s a reason the tummy tuck is also known as the “Mommy tuck”. During pregnancy, the abdominal muscles can stretch so much that they actually separate in some women – known as diastasis recti. And while exercise can reduce the extent of the muscle separation, it cannot completely undo the damage. That’s why some women choose to improve their look with a tummy tuck, in which the linea alba is folded (or plicated) and sutured together, creating a tighter abdominal wall.

The number of tummy tucks done in the US has climbed 88.7 percent since 2000, to 110,323 in 2009, writes HallyLevine on “Almost half of these procedures are done in women in their 20sand 30s, a sharp shift from a decade ago.” Levine says, quoting US cosmetic surgeon Dr P Haeck, that the average woman having a tummy tuck is now a young mom under the age of 35 with two small children. “She feels that she gave up a lot with changes in her body during and post-pregnancy, and she doesn't want to wait years to reestablish how she used to look. She wants her prebaby body back now," said Dr Haeck.

Abdominoplasties are one of the larger operations from a healing and recovery perspective,” says Dr Shaw. “They are, however, the most appropriate and necessary for most tummies after pregnancies. They address most of the issues that arise including separated and stretched muscles, which can lead to bulges and bad posture. This often includes hernias around the belly button. Fat is also reduced. Excess skin, particularly below the belly button (including most of the stretch marks!) is removed and the muffin top smoothed by repositioning the belly button to a higher, more youthful postion. The shape of the waist is regained by muscle tightening, and the shape of the bellybutton is returned to a more vertical appearance. The tightened muscle is the reason for prolonged discomfort, which feels like you’ve done too many situps. This operation is advised for those not expecting any more pregnancies.”

Breast Lift Surgery

There’s a myth that breastfeeding makes your boobs sag. But although breastfeeding temporarily affects the look and feel of your breasts, the American Society of Plastic Surgeons says it’s pregnancy itself that causes sagging. Other factors are smoking, older age, larger pre-pregnancy bra size and number of pregnancies a woman’s had.

This is why breast lift operations are becoming more popular among thirty- and forty somethings who want to arrest the sag and reverse gravity.

The droop that occurs with any atrophy or loss of volume is obviously most noticed after a pregnancy,” explains Dr Shaw. “This also happens when we are young, and still desirous of a great appearance at work and at play. The amount of sag is variable and can never be predicted, but is related to age, size of increase and decrease of breast volume, and genetic skin factors.”

“All that may be necessary is for an implant to replace upper breast fullness,” he says. “More commonly, though, a lift of varying designs and ever increasing complexity is required, and an implant is added for volume replacement and to improve shape. I am often questioned as to the use of  fat as a filler replacement. This is a great and natural filler, but is severely limited in amount and postoperative requirements to maintain an adequate improvement and therefore not feasible in most ladies for this purpose. My opinion is that a round silicone prosthesis placed either in front or behind the pectoral muscle depending on the effect desired remains the best option for volume replacement in the majority of breasts. I do offer both as alternatives, as long as a full understanding of the outcomes and limitations is appreciated. Overall, this remains one of my most frequently performed and appreciated procedures.”

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