Kosmetik International Special, Top Medical 01/20
Being and becoming a mother is wonderful! But pregnancy leaves its mark. Often, postnatal exercise, dieting and sport are not enough to get the body back into shape. Surgical procedures can fulfil this wish.
After pregnancy, the abdomen is no longer as firm and the breasts are no longer as taut. The skin has often suffered from the usually significant weight fluctuations, which manifests in the form of stretch marks on the abdomen, thighs and buttocks. Other areas of the body can also change, particularly as a result of vaginal births. Many women do not want to come to terms with these changes. If the skin on the abdomen has been greatly stretched, such as after a twin pregnancy, many women desire a tummy tuck. Equally common is dissatisfaction with the breasts, which undergo particular changes due to weight fluctuations and breastfeeding.
Farewell baby bump
The abdominal circumference increases by around 40 cm; in a multiple pregnancy it becomes even significantly larger. Weight gain varies from woman to woman, but averages 18 kg. The condition of a woman's connective tissue is decisive in determining how well the abdominal skin can stretch and how well it returns to its original state after pregnancy. In general, during pregnancy, applying natural oils and moisturising creams can support the skin and may even help prevent stretch marks on the abdomen and hips.
Removing the "excess"
When multiple pregnancies or long-term excess weight have overstretched the connective tissue, even discipline and weight loss can sometimes fail to restore a flat stomach and slim waist. Female connective tissue also loses elasticity in the abdominal area in particular as it ages. Women complain of excess skin on the abdomen. When this is more pronounced, it is referred to as a so-called skin-fat apron. The excess tissue on the hips and in the abdominal area can be tightened by a tummy tuck (abdominoplasty).
Two approaches are distinguished:
- In a mini abdominoplasty ("minor" tummy tuck), the excess skin on the abdomen is removed and tightened without repositioning the navel.
- In abdominoplasty, larger portions of excess skin and subcutaneous fatty tissue between the navel and the abdominal fold are completely removed. At the same time, the abdominal wall muscles are also tightened. The navel is cut around and repositioned. To keep the operation scars as inconspicuous as possible, the incision for an abdominoplasty is made in the bikini zone. The horizontal scar runs above the pubic hair and later disappears beneath underwear or bikini bottoms.
Often, a tummy tuck is combined with liposuction in the flank area to achieve a slimmer waist and aesthetic shaping of the overall appearance. It is optimal if the tummy tuck is performed after family planning is complete or after weight loss has been achieved. The procedure itself is carried out on an inpatient basis under general anaesthesia and takes approximately 1.5 hours. Experience shows that two drains are placed, through which wound secretions are drained for two days. After two weeks, the sutures can be removed. We recommend wearing a supportive girdle for six weeks and planning two weeks of holiday to recover.
The stressed breast
During pregnancy, a fundamental restructuring takes place inside the breast: fatty tissue must give way to glandular tissue. The rapidly growing mammary glands and milk ducts require ever more space, and the filling fatty tissue must give way increasingly. By the end of pregnancy, the majority of the fatty tissue has disappeared. The increase in volume also makes itself felt in terms of weight: 400 grams can accumulate on each side. Breast tissue and skin must withstand maximum stretching and strain during this time. After the breastfeeding period, the mammary glands and ducts recede again, but the fatty tissue does not return to the same extent. The breast skin is also greatly stressed. If weak connective tissue is also present, sagging and drooping breasts are very likely.
Lifting and enlarging
Some women suffer greatly from their shrunken and sagging bust. Even if pregnancy and breastfeeding are a miracle of nature, many women do not want to live with the consequences. Breast reconstruction can then be carried out by means of breast augmentation, a breast lift, or a combined surgical procedure. In a lift, the breasts are raised and shaped to be firmer. The low-positioned nipples are moved to a higher, more "youthful" position. Breast augmentation can also achieve volume build-up. The patient should describe her expectations in precise detail in order to discuss the possibilities of augmentation with silicone implants or with her own fat together with the treating doctor. In the latter case, the required material is obtained by means of liposuction. This can be an advantage if the patient wishes to get rid of excess fat on the abdomen and hips. The processed fat is then injected into the breast for augmentation. The great advantage of this option is that the body's own material is used. However, this method of augmentation has its limits: the breast can only grow by one cup size. With silicone implants, there are almost no limits to breast augmentation in terms of size. It is important to note here that the size and shape of the breast should suit the woman and the circumference of her chest (more on this in the article from p. 6). The shape, length and prominence of the inner (labia minora) and outer labia (labia majora) can also vary considerably. They may be perceived as too long, too full or too slack. The vagina itself usually does not change after vaginal births. However, it is possible for the vulva to change in appearance. The labia may protrude more, which is entirely normal. Sometimes women feel "stretched out down below" after a natural birth.
Correcting the intimate area
All of this can limit women's quality of life and their aesthetic wellbeing. If a woman does not want to accept the changes in her intimate area, she has the option of labia correction. The vagina can be tightened by means of laser treatment or radiofrequency therapy.
- Labia reduction can be performed under local anaesthesia or brief general anaesthesia. It is a relatively low-risk procedure with a short absence from work, provided it is carried out by an experienced surgeon and the patient observes various behavioural guidelines afterwards. The position of the clitoris can also be altered in the process.
- Vaginal tightening by means of laser or radiofrequency requires several sessions within a defined period of time. Since only heat is used in this process, there is neither downtime nor restrictions.
A flat-rate price for a Mommy Makeover cannot be given. In general, one should first ask what goal is to be achieved with a procedure. How great is the degree of suffering? In a joint consultation with the treating doctor, the available options should be discussed – as well as where the limits lie. Once it is clear which procedures are appropriate, the costs for the Mommy Makeover can be evaluated.
In Shape
Mommy Makeover is a trend from the USA that has now also attracted great interest in Germany. If a pregnancy has left its mark, the plastic surgeon can help restore the body to shape with various procedures, provided sport and diets have not achieved the desired results. Depending on personal perception and changes to the body, various procedures can be carried out:
- Tummy tuck
- Breast lift or
- Breast augmentation
- Liposuction
- Intimate surgery
Corrections to a caesarean scar as well as treatment of stretch marks are also possible. All of these procedures are only worthwhile, however, once family planning is complete. Otherwise, a subsequent pregnancy or weight gain may reduce the beautiful result once again.
