After pregnancy, you may have lasting differences in your body that you wish to address with surgery. For some patients, the goal is to have a comprehensive change in the abdominal area, while others may be looking for a procedure that gives them less downtime while still providing results.
Liposuction and abdominoplasty are commonly considered during this time. They address different issues, and it is important to understand the scope of each and the results they can provide before deciding which fits your situation. At the practice of Dr Ellis Choy, you will always get straightforward information to help you make the right decision for you.
What Pregnancy Changes in the Abdomen
Pregnancy affects three separate layers of the abdomen: fat, muscle and skin. For some people, these areas heal on their own, and the abdomen returns to its pre-pregnancy shape. Others notice significant changes even years after pregnancy, despite living a healthy lifestyle. Much of how your body responds to pregnancy and the postpartum period is genetic.
Fat Distribution Shifts
Weight gain during pregnancy is expected, but the areas where the fat settles afterwards can be different from where it was before. Even if they return to their pre-pregnancy weight, some women find that their shape is different because fat remains in areas like the abdomen or flanks and is resistant to weight loss.
Abdominal Muscle Separation
During pregnancy, the two vertical bands of the rectus abdominis muscles stretch apart to accommodate the growing uterus. In many cases, this separation, known as diastasis recti or rectus divarication, persists for months or even years after childbirth. A long-term study in Scientific Reports found that muscle separation was still present in 36% of women three years postpartum.
Skin Elasticity and Collagen Loss
Skin has to stretch during pregnancy to allow the abdomen to grow, and its capacity to return to its firm state depends on collagen and elastin content, genetics, age and the size of the pregnancy. Multiple pregnancies or rapid postpartum weight changes can leave the skin loose below the navel, often with stretch marks. Once elasticity has been diminished in this way, topical treatments will not be able to restore the skin’s firmness.
What Does Liposuction Target?
Liposuction is a surgical procedure that removes subcutaneous fat through cannulas inserted beneath the skin. It is used to refine areas of stubborn fat that aren’t responding to lifestyle changes and is common on the flanks, hips, thighs and abdomen. Liposuction is a body-contouring procedure rather than a weight loss treatment, and its scope is limited to the fat layer. It does not repair separated muscles or remove excess skin, so the results will vary depending on skin quality and the condition of the abdominal wall.
What Does Abdominoplasty Address?
Repairing the Abdominal Wall Muscles
During abdominoplasty, sometimes called a tummy tuck, Dr Choy sutures the separated rectus muscles back into their original position along the midline. This step tightens the abdominal wall from the inside and can help resolve the abdominal fullness that is common after pregnancy, despite exercise.
Removing Excess Skin and Stretch Marks
After repairing the muscles, Dr Choy removes loose skin from the abdomen. Often, stretch marks that are located below the navel can be removed along with the excess tissue, but those above the navel will remain. The amount of skin removed will depend on how much laxity is present. The scar will be placed discreetly on the lower pelvis.
Refining Waistline Contour
The skin will be redraped over the newly repaired area and sutured into position with care to limit tension on the incision. For a full abdominoplasty, this will also require Dr Choy to reposition the belly button.
Why Many Post-Pregnancy Patients Choose More Than Fat Removal
After childbirth, some patients assume that the changes in their abdominal area are simply from excess fat. However, post-pregnancy changes usually come from a combination of factors, including muscle separation that won’t heal and skin laxity. Simply removing the excess fat will often not produce the results the patient is looking for.
Dr Choy’s approach to post-pregnancy body contouring involves a full assessment of all of the three tissue layers to find out which are affected. From there, he can recommend the surgery that will provide the most comprehensive results.
Signs That You May Benefit From Both Procedures
- A Visible Bulge Along the Midline When You Sit Up: Diastasis recti is often noticeable by the dome-shaped bulge that appears down the centre of your abdomen when you sit up or engage your core. Sometimes, this can be addressed through special exercises, but other times surgery is the best option for repair.
- Skin That Stays Loose or Creased: If you have reached your pre-pregnancy weight, but you have loose skin that hangs below your waistline, you may be a good candidate for abdominoplasty.
- Stretch Marks Concentrated Below the Belly Button: Stretch marks are caused by deep dermal changes and cannot be removed by fat reduction. If they are below the belly button, they may be removed along with excess skin during an abdominoplasty.
Recovery Differences Between Liposuction and Abdominoplasty
Recovery From Liposuction
You will wear a compression garment for several weeks to help with swelling and skin contraction. Patients can return to desk work within around a week and incorporate light exercise around four weeks post-surgery. Bruising and swelling are common with this surgery, and full results can take several months.
Recovering From Abdominoplasty
This surgery is more extensive and involves a hospital stay of one or two nights and the placement of surgical drains. You will wear your compression garment for six to eight weeks and walk in a slightly stooped position for the first week to protect the muscles as they heal. It can take up to 12 months for swelling to fully resolve, and up to 18 months for the scar to mature and fade.
Timing Your Surgery After Pregnancy
You should wait at least six to twelve months after birth before considering abdominal surgery. You will need this time for your muscles and skin to settle and for your weight to stabilise. Once you have had the surgery, additional pregnancies can undo your results. Dr Choy recommends delaying surgery until you have completed your family.
Book a Post-Pregnancy Surgery Consultation With Dr Choy
To discuss all of your options with Dr Choy and learn more about which procedure fits your situation, contact the office of Dr Ellis Choy on (02) 8962 9388 or through the website. Consultations are available at his Sydney and Coffs Harbour rooms, and all surgery is performed in accredited hospital facilities. Individual results, risks and recovery are discussed thoroughly at your consultation.
Categories: