Post-Partum
This is an indefinite period of time following childbirth.
It is associated with severe physical, sociological and mental changes.
Tissues of the body that were altered by the pregnancy will return towards the pre-pregnancy status but may not meet them. The uterus will involute, tears of the vagina may heal, overstretching of the muscles of the pelvic diaphragm may not return to normal, leaving a degree of stress incontinence.
The breasts will have swollen during pregnancy, and will remain swollen if she feeds her baby(ies!). Stretch marks on breasts and abdomen may have formed.
Posture is altered by the weight of the pregnant uterus, back pain may have been initiated. Sacroiliac and pubic symphysis joints need to become firm again. The addition of a child to the family poses financial and other problems, all the more so when there is not the traditional family, too common these days in North America.
Birth of a child is very commonly associated with a degree of post-partum depression, “the blues,” which may be so severe it needs treatment; for all mothers the care giver should be aware of its probability which the mother may not assess correctly herself.
At some time after the surgery, when mental and physical states are quiescent, the new mother may find she wishes to seek treatment for unresolved physical aspects of her pregnancy, such as the striae gravidarum or excess abdominal skin.
This case depicts a 41 year old woman who had borne one child via c-section. Because her skin had remained relatively undamaged by the distensing effects of pregnancy, she elected to undergo abdominal recontouring by liposuction, A previous pregnancy does not indicate that an individual is not a candidate for liposuction of the abdomen.
In some instances, both liposuction and an abdominoplasty may be possible. Each has different pros and cons, which must be discussed prior to selecting the appropriate method. The post-operative photographs depict this woman's appearance approximately 3 months after surgery.
This case depicts a 33 year old woman who was fit, slender and had never been pregnant. She had, however, a genetic tendency to accumulate fat in the mid-body- front and back. Because she had excellent skin tone and skin elasticity, this type of individual was the optimal candidate for liposuction.
Once the excess fat is removed from beneath the skin, the skin will shrink down and hug the new body contour without any sagging. The incisions required for this type of body contouring are a few millimeters in length. Notice the significant change in this woman's body shape to a desirable "hourglass".
This 24 year old woman had a breast lift or mastopexy to correct sagging of her breasts that occurred as a result of changes related to pregnancy. I used a short scar breast lift or mastopexy technique which leaves behind scars shaped like a “lollipop.” Some breast lifts or mastopexies are performed using a technique that results in scars that look like an “anchor,” but I prefer to use this shorter scar technique because scars are never visible in the cleavage nor on the side of the body beneath the arm. This makes swimsuit selection much easier.
How the breasts will change as a result of pregnancy varies from one woman to the next. Some women’s breasts look very similar after pregnancy. Others change drastically in their appearance after even a single pregnancy.
This woman was fortunate to have enough breast tissue to rearrange into a relatively full and natural appearing breast without the need for an implant.
Skin elasticity, which refers to the ability of skin to “snap back” after being stretched, also varies from one woman to the next. In people who have poor elasticity, surgical results do not last as long. In such people, using an implant to replace volume can predispose that individual to an earlier recurrence of the initial problem because the implant has weight and taxes already compromised skin. Commercially available skin substitutes can provide the strength needed for successful use of implants in such cases. Use of such substitutes adds expense and complexity to the surgery, however.
This case depicts a 51 year old woman who was delivered of two children by c-section. Both her abdominal skin and abdominal wall had been stretched during her pregnancy, giving her abdomen a less taught appearance. These post-partum changes are not typically response to diet or exercise.
Although abdominoplasty incisions can vary in length, a portion can be placed within an existing transverse c-section scar. Often, the entire incision is relatively easy to hide, even when wearing a two piece swimsuit. The post-operative photographs depict this woman's appearance approximately one year after surgery.
This case depicts a 44 year old woman who had borne four children and was most concerned with excess skin, which was severely affected with stretch marks, on her abdomen. Such individuals are optimal candidates for an abdominoplasty or "tummy tuck." While many of the stretch marks can be removed during this surgery, even those that remain are less noticeable when the skin is taught. An abdominoplasty is also designed to tighten the abdominal musculature, which may also be stretched or malpositioned as a result of pregnancy.
The post-operative photographs depict this woman's appearance approximately one month after surgery.
This case depicts a 29 year old woman who after bearing three children had become concerned with the protuberance of her abdomen. In this case, both stretching of the abdominal wall and excess fat beneath the abdominal skin were contributing to the unfavorable contour of her abdomen.
She had moderate but not severe stretch marks over her abdomen, the majority of which were removed in the surgery.
Dr. Belsley's Philosophy of Breast Augmentation
When it comes to deciding what approximate breast size you wish to achieve, the best advice I can give you is that you should be guided by your physical frame. Indeed, you may in fact be limited by it. In my practice, I select implants based upon your chest measurements, the quality of your breast skin and the size of your breasts prior to surgery.
I perform breast augmentation through a peri-areolar or inframammary approach and I place that vast majority of implants at least partially beneath the pectoralis muscle. My patients are welcome to select either saline or silicone filled breast implants. Silicone filled implants can in some cases achieve a more natural feel and may be a particularly attractive option for women with less breast tissue prior to surgery.
More >>Dr. Belsley's Philosophy of Breast Lift (Mastopexy)
In my practice, I perform breast lifts using incisions that result in a “lollipop” shaped scars. With good care and a bit of luck, these incisions heal well and the scars are difficult to see from a distance. Nevertheless, a woman who undergoes a cosmetic breast lift must be prepared for scars that are visible. This is one example of a “trade-off” in plastic surgery and of course, there are many others. This is one, however, that I feel is more than worthwhile in appropriate candidates.
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