Over recent years, I’ve seen an increasing number of female patients seeking plastic surgical solutions to the effects of pregnancy on their bodies. This is an acknowledged trend worldwide and plastic surgeons in the USA first coined the phrase ‘Mummy Makeover’ to describe the phenomenon of body contouring procedures aimed at both the abdomen and breasts.
Pregnancy has a profound impact on a woman’s body – some of my patients have described it as “devastating” – particularly the abdomen and breasts. As the womb expands to accommodate the baby, the central, vertical abdominal wall strap muscles stretch and separate to a greater or lesser degree. This may cause irreversible fullness of the tummy and even, at its severest, a ventral hernia, the tummy contents pushing through the central weakness to lie just under the skin. The overlying skin, of course, also stretches at the same time.
The breasts are also affected by the pregnancy as they generally increase in size and their tough, supportive, connective tissue fibres stretch as the breasts become more heavy and full. Breast feeding, whilst absolutely the best thing for the new baby, causes collateral damage to the breast tissues through continued engorgement with milk. Often the stretched effect on the skin and connective tissues does not recover when breast feeding is stopped, causing many women dissatisfaction as their breasts feel loose and empty. Loss of cleavage is also a popular complaint as fullness is principally lost in the upper part of the breast.
Turning to the tummy, age, the amount of weight put on during pregnancy, the size of the baby, multi-birth pregnancy, multiple pregnancies and inherited genetic make-up are all factors in how your body shape will change during and after pregnancy.
Although it is possible for the body to snap back to its pre-pregnancy shape, many women are left with the ‘battle scars’ of pregnancy, long after the baby is born. Skin stays stretched and the abdominal muscles fail to knit back as tightly as before, meaning it is impossible to regain a toned abdomen, however stringent a diet and exercise routine is followed.
Although plastic surgery post-partum is nothing new, the increase in women seeking plastic surgery procedures to reshape and restore the body seems to be down to a change in attitude. Reflecting the times in which we live, many women, more aware, empowered and self-confident than ever before, are not prepared to simply shrug their shoulders and just accept these changes as their permanent lot.
So, what are their surgical options?
A ‘Mummy Makeover’ is a marketing term and doesn’t describe an actual surgical procedure. It is a loose term that covers a number of different surgical procedures that can be combined into one lengthy operation. The main procedures are aesthetic breast surgery aimed at restoring breast shape, tone and, often, volume and a ‘tummy tuck’ that will improve abdominal appearance and tone.
The most likely breast procedures are augmentation and/or uplift (medically known as a mastopexy). Occasionally some degree of reduction is appropriate. During the consultation for my patients from Warwickshire, Coventry and beyond, I perform a thorough physical examination to identify, and then discuss with them, what procedure would best suit their needs.
The correct procedure choice is crucial. Often a woman will feel she needs a breast augmentation because of lost fullness in the upper pole of the breast. However, if she also has more than just slight sagging, inserting an implant will only make the appearance of the breast worse with time, the implant dragging the breast downwards by gravity and resulting in the breast volume being too low down. A mastopexy, utilising and lifting her own breast tissue to a more natural position, higher on the chest, whilst also tightening the skin ‘envelope’ a lot, will often produce a much better result more nearly fulfilling her hopes and expectations, although sometimes some degree of augmentation will also be required.
A ‘tummy tuck’ (known medically as an abdominoplasty) will vary in extent depending on how much needs to be done. If a ventral hernia is present, a complex repair is required to try and prevent it ever happening again. I carefully stitch stretched and separated abdominal muscles together again, before removing any excess skin and fat to produce the final result. A small but definite sector of my patients are women who are otherwise very slim and toned but are unable to strengthen the area below the belly button because of muscle looseness post-pregnancy. A mini-tummy tuck is an ideal procedure for these women as it focuses on this area alone.
As with all the plastic surgery procedures I offer, prospective patients can speak to former patients, who have had a particular procedure or combination of procedures done, so they can get a clearer idea of the results that are achievable and what the experience will be like from the patient’s perspective.