Giving birth to a baby is one of lifes supreme joys. But after its all over, and we start returning to our former selves, sometimes we arent 100% pleased with our new shape. That pouch of extra fat and skin below the belly button sometimes wont flatten out again, especially after the second or third baby. The muscles, fascia, and skin have been stretched to accommodate the baby, and even though breastfeeding helps to pull them back into shape, and proper diet and regular exercise continue to help, sometimes they remain stretched-out. If the belly hasnt reverted to its pre-pregnancy flatness by the end of 6 months, it probably will never do so without help. So perhaps we start to wonder about getting a tummy tuck.

Further Pregnancies

If you think you may get pregnant again, postpone the tummy tuck until thats all over. A pregnancy after the tummy tuck could undo all the work, wasting your money and putting you back where you started.

Tummy tucks and the structures of the abdomen

Right below the skin is the stuff we dont want: the fatty tissue. Below that is the fascia. Fascia means a sheet of tough connective tissue, mostly collagen (which is a protein we have in bones, muscle, skin, and throughout our bodies). This particular fascia is our natural girdle. Its a sort of fibrous fabric that extends from the ribs down to the pubic bone, across the whole width of the abdomen. When its not stretched out of shape, it keeps our tummy flat, with the cooperation of well-toned muscles. Below the fascia are the muscles. In a tummy tuck, these are not exposed and not worked on. We might read that a tummy tuck will tighten the muscles, but really it tightens the fascia which lies over the muscles.

What causes the belly bulge is this stretched fascia, which isnt as resilient or elastic as muscle tissue. What does a tummy tuck do?

Briefly, a tummy tuck (abdominoplasty) removes extra fat and skin from the abdomen and tightens the abdominal fascia. This flattens the tummy and sometimes narrows the waistline as well, since excess tissue is removed. Many times, the belly button is moved to a new location to match the new contours. Tummy tucks are usually done in a hospital or surgical center, with general anesthesia, although your stay will be just one overnight. They take anything from 1 to 4 hours, depending on how much tissue is to be removed. When he sutures the incision closed, your cosmetic surgeon will place a drain under the skin, or perhaps two. They prevent fluid from pooling under the skin (seromas), by removing the excess fluid. Therell be a scar, but below the bikini or underwear line.

Mini tummy tucks

A mini tummy tuck does the same things, but focuses only on the lower abdomen, below the belly button. A full tummy tuck procedure works on the entire abdomen, up to the ribs. Mini tummy tucks are done on an outpatient basis, usually with local anesthetic and some IV sedation. They leave a smaller scar, low on the abdomen as with a full tummy tuck. Combining the tummy tuck with other procedures Tubal ligation If youre very clear in your mind that you want no more pregnancies, your tummy tuck can be done at the same time as a tubal ligation (tying your tubes). Hysterectomy If your doctor advises you that you need a hysterectomy, it can be done along with the tummy tuck.

Liposuction

Since fatty tissue is removed in a tummy tuck, the procedure can be done with liposuction. What a tummy tuck will not do It wont remove stretch marks from your abdominal skin, but simply move them lower down. If the layer of fat in your upper abdomen is very thick, a tummy tuck wont remove it all. Sometimes liposuction can remove some, but too much liposuction of this upper area, done at the same time as the tummy tuck, can affect blood circulation and cause complications. Recovering from a tummy tuck At first therell be pain, swelling, and numbness, but not bruising. The plastic surgeon will have applied bandages and inserted drains. Pain: Your surgeon will of course prescribe a pain medication and youll probably take that for a week or two.

Swelling: The swelling should subside within 5 or 6 weeks, perhaps as soon as 2 weeks. Numbness: The numbness may last several months but is normally not permanent. Drains will be removed when drainage eases up, after a couple of days, or maybe after a week or two. Avoid taking any showers until theyre removed; just take sponge baths. Bandages are removed after 3 or 4 days. Youll feel like resting, but dont rest all the time. To encourage good blood circulation, you should walk around every hour or so and perhaps do light household chores. But avoid anything that feels uncomfortable. Wiggle your feet periodically and keep your hips gently flexed forward, to avoid putting tension on the stitches.

You can take baths after about two weeks. Therell probably be surgical tape over the stitches and you should leave it on until it comes off by itself, or until your surgeon removes it. In the meantime, keep it dry. If your work isnt physically active or strenuous, you can be back after a week or 10 days. Otherwise, its wise to wait for a month or 6 weeks. You can drive again after you stop taking the pain medication. After a month, you can be back at the gym or jogging etc. The final result wont be fully evident until the scar heals, in about a years time.

Finding a good cosmetic surgeon

Since cosmetic surgery has become so popular in the last 10 years or so, some doctors have taken short cut training to take advantage of this at a disservice to the general public. You want a properly trained and experienced plastic surgeon, not one who might gain his basic experience on you! Choose a plastic surgeon whos certified by the American Board of Plastic Surgery (ABPS), and one whos a member of the American Society of Plastic Surgeons (ASPS) and the American Society for Aesthetic Plastic Surgery (ASAPS).

While you should by all means listen to your friends and acquaintances who may have had cosmetic surgery and want to recommend their doctor to you you should do your homework too, and check the doctors credentials.

Some questions to ask when interviewing plastic surgeons
Do you have hospital privileges, and if so, which hospitals?
Can you do the procedure in the hospital if I want to?
If you do surgery in other facilities, are they accredited?
How many breast reductions have you done?
Can I speak to some of your previous patients about their experience with it?