Babies are wonderful and beautiful…but stretch marks and loose, saggy abdominal skin are not! Whether they admit it or not, every new (and not so new) mother is anxious about getting her “pre-baby body” back. This concern over recovering from pregnancy and the birth of a child has many women asking Dr. Traci Temmen, “How long should I wait to have a tummy tuck after pregnancy?”
Abdominal Wall Changes During Pregnancy:
Everyone knows that abdominal skin stretches during pregnancy. However, in actuality, all layers of the uterus, abdominal wall, and skin stretch during pregnancy to accommodate the growing baby. The uterus, which is usually the size of closed fist, increases to the size of a large watermelon at the time of a term pregnancy. The abdominal wall muscles, particularly the rectus abdominis muscles (a.k.a. the “six-pack” muscles) and the connective tissue between the two muscles, stretch in a vertical as well as horizontal direction making them thinner, longer, farther apart, and weaker at the time of delivery. Finally, the abdominal wall skin (and occasionally the skin of the back, flanks, buttocks, and thighs) stretches rapidly and circumferentially, which sometimes results in stretch marks and/or a loss of skin elasticity.
Abdominal Wall Recovery After Pregnancy and Delivery:
Immediately after delivery of a baby, many women are disappointed to discover that they still look six months pregnant. This is due to many factors. It takes at least six to twelve weeks for the uterus to shrink to its original size after the birth of a child. An enlarged uterus is a major contributor to the immediate post-baby belly “pooch.” It takes even longer, between six and twelve months, for the abdominal muscles to strengthen, tighten, and return to their original position. Unfortunately, while the rectus abdominis muscles generally strengthen over time, it is not uncommon for the thick, dense fascia between the lower rectus abdominis muscle to stay thinned and separated. Abdominal fascia lacks the ability to recoil the same way as muscle after significant stretching and trauma. This area of weakened rectus muscle fascia, usually below the belly button, is called a rectus diasthesis if greater than two fingerbreadths can be felt separating the two rectus muscles after the birth of a baby. Rectus diasthesis is a major contributor to a long-term “mommy tummy” and one of the most common indications for a tummy tuck in post-partum women. Finally, similar to the rectus muscles, the abdominal skin also needs between six and twelve months to contract. Unfortunately, while stretch marks will not disappear, they do fade and lighten over time. Stretch marks that are initially wide, deep, and bright red or purple, will become light, thin, and shallow within several months to two years.
When to Have a Tummy Tuck After Pregnancy:
Because it takes at least six to twelve months for all the soft tissues of the pelvis and abdominal wall to contract and recoil as much as possible, Dr. Traci Temmen tells all her patients at the Plastic Surgery Center of Tampa to wait at least six months after the birth of a child before proceeding with tummy tuck surgery. This six to twelve month time period also allows time to lose the “baby weight,” ensuring the flattest, tightest post-operative belly possible. If a tummy tuck is performed before the soft tissues and skin of the abdomen have had time to contract and recover from pregnancy, the abdominal skin will be loose and patients may have a lower abdominal bulge once contraction is complete. This, obviously, is not the ideal result and defeats the purpose of performing a tummy tuck in the first place!
Tummy Tuck Immediately After A C-Section:
Not only does it not result in an effective tightening of the abdominal skin and soft tissues (as described above), but performing a tummy tuck immediately following a Cesarean-section is dangerous and potentially life threatening. In the initial postpartum period, women are at an increased risk for blood clots in the legs and/or lungs. Any type of surgery, particularly an intra-abdominal surgery like a Section-section or a tummy tuck, significantly increases this risk of blood clots and/or death. For this reason, Dr. Temmen (and most other reputable plastic surgeons) would never perform a tummy tuck surgery immediately following a C-section or vaginal delivery of a baby.
For more information on the prevention and treatment of stretch marks, please see Dr. Traci Temmen’s blog from April 2015 titled: Here’s the Skinny on Pregnancy Stretch Marks.
For more information on scheduling a tummy tuck surgery after the birth of a child, or to schedule a free tummy tuck or mommy makeover consultation, please call Dr. Temmen today at 813-877-2277.