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The Ultimate Body Lift

Posted: Thursday 24 June 2010 03:23pm

By Dr Michael Miroshnik, Plastic Surgeon

Although having a child is one of the most fulfilling experiences in a woman’s life, it comes at a certain physical price that just about every mother knows of! The gravid uterus, hormonal fluctuations, weight changes as well as the breastfeeding process all have a physical aftermath on the body that makes most women wonder what can be done to reclaim what they once had.

Post-pregnancy physical changes to the body seem to affect some women more harshly than others and certain body parts are particularly susceptible to change following the stresses endured during the gravid state. The abdominal area and breasts, as they are directly involved in the process, usually experience the most obvious changes.

Other secondary areas however, such as the arms, buttocks, thighs, labia minora and lower legs are often also adversely affected due to the weight and hormone fluctuations that occur. Moreover, changes within the skin itself are a frequent finding by most mothers. Features such as cellulite, stretch marks (striae) and skin thinning may occur; again being reflective of the major physical and hormonal changes that a woman has undergone during her pregnancy period.

While the desire to undergo a full body restoration is probably something that most mothers think about at some point, it is still only a relatively small percentage of women who use a methodical approach to prioritise and address each of their concerns in turn. Desires sometimes seem ‘unobtainable’ or simply ‘too difficult’ for many women and they dismiss such thoughts.

However, by setting clear surgical goals, maintaining a concurrent healthy lifestyle and implementing a well thought out plan – results that may seem distant become a reality relatively quickly. Some individual desires such as weight loss alone can effectively be addressed with a good diet and exercise, whereas others such as reshaping and recontouring will never be achieved without the aid of effective plastic surgery.

It is important to note that there are multiple factors to consider when planning to undertake significant makeover surgery. I ask my patients to rank their individual concerns in an order which is important to them so that a tailored approach can be adopted where the areas of most concern are addressed first and lesser areas considered later.

To see the results of Case 1, click here

Correcting multiple discerning issues in one large surgical procedure has become known as the modern-day “yummy mummy makeover”. With the increase in safety of both surgical and anaesthetic techniques, longer procedures are tolerated quite well by most healthy women and allow several areas to be corrected at once so that recovery is simultaneous.  Indeed, the most common combination of procedures to combine under the one anaesthetic is surgery of the breast and abdomen.

The procedures are best performed on women who have finished having their family, have had a stable weight for at least six months, are non-smokers and have been involved in some sort of exercise program. I always try to get women to be within 5kg of their ideal body weight prior to surgery. It is also worth noting that these makeover procedures are not just for recent mums, they are equally successfully performed in many who have waited several years before treating themselves.

The anatomical areas that tend to bother women post-pregnancy are:

THE ABDOMEN

This is often the most significantly affected area after childbirth, with the breasts a close second.

As the uterus expands throughout the pregnancy term, the midline abdominal muscles (rectus abdominis muscles) are stretched outwards becoming separated in a condition known as Diastasis Recti.

At the same time, the umbilicus (belly button) is also stretched and changes its shape from a more vertical slit like appearance to one that is larger and horizontal. Sometimes a small hernia may also develop during this process making the umbilicus bulge outwards.

The skin of the abdomen is similarly expanded and develops stretch marks (striae) particularly in its lower portion where most of the forces are applied. At this stage, or even some time after, new hormonally influenced fat deposits may also appear which tend to be quite stubborn to traditional weight loss methods.

These changes are extremely familiar to most mothers and the degrees to which each individual is affected is influenced by many genetic and environmental factors such as age, skin type, pre-pregnancy weight, diet, smoking and level of fitness. Many of them are unfortunately permanent and cannot be spontaneously reversed regardless of how much one tries with measure such as exercise. They need to be treated by surgery. The operation which addresses all these concerns is known as an abdominoplasty (or tummy tuck).

To see the results of Case 2, click here

There are various different types of tummy tuck including the mini, full, endoscopic, extended, high lateral tension, central and circumferential (or belt lipectomy). In addition, liposuction is an excellent adjunct and often used in association with most tummy tuck procedures. The exact choice of operation should be decided after careful assessment and consideration of all the patient’s goals.

The usual ‘full’ tummy tuck procedure usually involves restoring a taut and toned abdomen by removing excess skin (along with striae), fat and at the same time tightening the abdominal musculature. The rectus diastasis is repaired all the way from the rib level downwards and the umbilicus is reshaped to become more vertical and youthful as well as repositioned to a better location. Any incidental hernias are repaired concurrently.

BREASTS

The breast feeding process and milk reflex causes measurable loss of volume, shape changes as well as droopiness that again cannot be readily restored by the body without surgery. Women may notice stubborn stretch marks as the upper pole volume of their breasts is diminished. In addition, the nipple/areolar area may become adversely enlarged, pigmented and asymmetrical. These changes together can completely change the way a woman perceives her femininity after having children.

To see the results of Cases 3 & 4, click here

To reverse these changes and give back the breasts their former perk a number of procedures may be utilised. Again, I ask my patients to rank in order all the things they dislike or want to improve about their breasts and tailor an operation that best meets their needs. Options include a breast lift, augmentation, reduction, nipple/areolar reshaping or a combination of several of these procedures. It is a good opportunity for a woman to decide whether she wants to be larger, smaller or remain about the same size as these can be factored into the final choice of procedure.

ARMS

Undesirable changes of the arms range from a simple excess of fat, to that of excessive skin, stretch marks as well as fat. This may lead to what some would refer to as a ‘chicken wing’ appearance to their arms which produces an overall flabby and undesirably wobbly look. These can be addressed via a procedure known as a brachioplasty (arm lift) depending on what the principle concerns of the patient are.

THIGHS/BUTTOCKS

Stretch marks, stubborn deposits of fat and excessive skin/droopiness herald the changes in these regions. Depending on what precisely is the concern, a combination of liposuction, thigh lifts
(outer or inner), buttock lifts or augmentations can be used to reverse the changes that have occurred.

In some who have been particularly affected or who have had concurrent significant weight loss, a lower body lift is sometimes the solution to address all of the above problems in one go!

LABIA

The labia minora, or inner lips of the vulva, are often the most affected parts of the external genitalia post pregnancy. Changes include elongation, pigmentation, asymmetry and the appearance of skin tags. These can be addressed with an effective procedure known as a labiaplasty which is a relatively short procedure when compared to some of the others that we have talked about and hence easily added on as an accessory procedure to one of the above.

by Dr Michael Miroshnik

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