An abdominoplasty or “tummy tuck” does require general anesthesia and can take up to several hours in the operating room. The length of time for the operation depends on the amount of skin that needs to be removed and how large a tummy you have.

If you are of “good health,” that is, if you do not have health problems with your heart and lungs, and have been cleared of any previous heart and lung problems, then you are a candidate for a tummy tuck or what I call a MOMMY MAKEOVER.

You also MUST be cigarette smoke free for at least 2 weeks before and for 2 weeks after the surgery. In fact, better results are had by those who don’t smoke at all in terms of better incision healing and fewer wound healing complications.

During a tummy tuck, I repair the rectus muscles that have become split as a result of pregnancy or perhaps were split even from birth. The result is a trimmer shape and waistline!

It is misleading to think that you will be able to sustain your new shape and size after plastic surgery if you are not willing to change your eating habit and/or exercise habits. While I will change your body absolutely remarkably in a way that you couldn’t have with diet and exercise alone, your shape will not be maintained if you don’t watch what you eat afterward.

My suggestion then is to get into the habit of at least walking 2-3 times a week to begin with for 10-15 minutes at a time. Once you get used to that level of activity then you should progress to at least 30 minutes 3 times a week then to everyday.

When I speak of changing eating and lifestyle habits, it can be as simple as portion control and giving up regular soda and skipping dessert 2-3 days a week and limiting the amount of carbohydrate intake without giving it up entirely.

A tummy tuck is an absolutely EXCELLENT way of getting rid of all your excess skin, stretch marks and fat that overhangs your midriff after children or weight fluctuations. In fact, it is the ONLY way to get rid of all that excess skin. You can lose the weight and tone up the abdomen with exercise and diet but  become extremely frustrated and discouraged when you see that torso has not changed one bit and in fact may look worse with the weight loss, when the skin looks even more saggy and flaccid.

Many of my patients such as yourself will come for a consultation when their weight loss or shape change plateaus with the exercise and diet and want to know what more can be done. This is an extremely important time not to “fall off the wagon, become discouraged” and bounce back to your previous  destructive eating binges and habits.

This is an ideal time to intervene with plastic surgery which can take you to the next level of a healthier lifestyle and new body. The tummy tuck is the “kick in the rear” that you need to stay on track and to maintain your healthier lifestyle.

When you can actually SEE the results of all your hard work with an incredible new body shape, you are much more willing and likely to maintain this new lifestyle permanently.

I hope this is encouraging and helpful and I will write more on the costs and recovery in my next MOMMY MAKEOVER BLOG.

Dr Michele D Koo, MD, FACS, St Louis, Missouri, 314-984-8331, Board Certified Plastic Surgeon, Member of the Aesthetic Society believes that weight loss after pregnancy can be achieved with sensible eating habits and increasing one’s activity level. She does not think that one should worry about the weight gain during the pregnancy as long as your OB-GYN is following your rate of weight gain and which trimester you gain the most weight.

Fat deposits and weight gain is a normal part of pregnancy and is necessary for the healthy development of normal birth weight newborn. Fat accumulates during pregnancy in the same areas that plague most women even when not pregnant. The most common female areas of fat accumulation are the abdomen, hips, waist, inner and outer thighs.  The areas of fat accumulation are genetically determined that cannot be altered with diet and exercise. These are the areas that increase in size first any time there is any weight gain regardless of pregnancy.

The fat that is accumulated with pregnancy is a rapid weight gain type of fat that increases the size of the fat cells over a short period of time. There usually is not enough weight gain of 75 lbs and up that might actually stimulate the body to trigger the cells to multiply and increase the actual number of fat cells.

Short term weight gain such as with pregnancy should actually be easier to lose than weight that has accumulated over a long period of time.  Fat that has accumulated over a long period of time of years may be a result of an increase in number of fat cells and even fat deposit in the composition of muscle and internal body fat gain.

The body’s physiology may also have been altered in terms of its insulin release and response patterns, fat storage, other endocrine functions, and possibly set points for “normal weight.” However, during the post partum period, the woman may be recovering and exhausted from a newborn and perhaps other small children and attempting to return to work, and, therefore, not really devoting time and energy into healthier eating and exercising habits.  The weight then seems to be extremely “stubborn” and resistant to exercise and weight loss, but in fact the fat is very readily reduced with the same diligent adherence to exercise and healthier eating.

It is my opinion that if after 1 to 2 years post partum, a woman has not lost all of her pregnancy weight, she will not be able to do it. More importantly, even if she achieves her pre-pregnancy weight, she will not look the same unless all of the skin has tightened which becomes less and less likely with each subsequent pregnancy.

My recommendation to my patients is that, they wait 6-12 months after they have stopped breast feeding or at least 6-12 months after delivery prior to undergoing any liposuction procedure as at that point, the post partum weight is relatively stable.

It has been my experience, however, that most women after pregnancy will need some type of skin removal procedure, i.e., tummy tuck, breast lift in addition to liposuction to achieve what they are looking for. The likelihood of needing a skin resection procedure increases with a C-section and increases with the number of children a woman has had.  I discuss this at length with my patients, the pros and cons of the permanency of the scar versus the great shape that can be achieved with the addition of the skin removal.

My patient’s ultimate goal of how flat she wants her abdomen or smooth her thighs will determine whether she would be better served with liposuction alone or liposuction with skin removal. The amount of time to recover after a liposuction is not any different for post partum patients; the amount of time to recover is dependent on the amount of fat removed and the number of areas liposuctioned.

With each pregnancy there will be weight gain and skin stretching; if one is considering any kind of plastic surgery for post partum changes for unwanted fat and skin, one might want to wait until they are completely finished with having children. The most important thing that one should always know is, “that there is nothing that pregnancy or weight gain can do that Dr Michele Koo can’t fix.”

DR MICHELE D KOO, MD, FACS, ST LOUIS, MISSOURI, 314-984-8331 for individualized personal care that will change your life and let you take charge of your own destiny.