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Regaining Shape after Childbirth: Mommy Makeovers!


CosmeticSurgery.com Staff Report
Medically Reviewed by Don Revis, M.D.

Many women are establishing the career track before tackling the mommy track. And because they tend to have higher incomes and often go back to work after childbirth, they want to be confident about their appearances as well as have their old shapes back. Often a “mommy makeover” is the result.

When now 45-year-old Ellie Malmin of Lake Worth, Florida, took a train trip with her seven and three-year-old children, she looked up and smiled pleasantly at the woman seated across from her. All of a sudden, the stranger dropped a remark that stuck in Ellie’s mind.

“You have such beautiful grandchildren,” the woman said.

The innocent remark stopped Ellie in her tracks and made her take stock in her appearance. Although Ellie works as a makeup artist, her teeth had permanent stains as a side effect from a regime of tetracycline. But her biggest concerns were caused by bearing two children near her 40th birthday. It was especially hard on Ellie because she stands only five foot tall and her normal, pre-pregnancy weight tipped the scales at exactly 105 pounds. Childbirth had stretched Ellie’s stomach muscles and left her with a lot of loose, hanging skin around the waist. Her diminutive frame carried almost 30 extra pounds, all of which was left over from pregnancy and childbirth.

Moreover, many late hours in her business created dark circles and bags under her eyes.

“Like many women, I wanted to be the perfect mother and gave virtually all my time and attention to the children,” Ellie told CometicSurgery.com. “I got to the point where I had put myself at the bottom of my priorities and even went around without makeup. In a word, I had become a frump.”

While she was taking stock, Ellie also started thinking how her appearance might affect her children. After all, the children see loads of ideal beauties every day, thanks primarily to the media, and then make comparisons to mom, the real woman they see daily.

“If I lose respect for myself, my kids may also lose respect for me and then themselves,” Ellie thought, “Perhaps the children would have a better role model if they saw me as more outgoing and confident – and not so frumpy.”

Eventually, Ellie decided her outward appearance should match the youthful, attractive person she felt to be deep down inside. So she went to the Advanced Aesthetics Institute in West Palm Beach, Florida, and underwent a tummy tuck, (to tighten the abdominal wall,) eyelid surgery (to erase bags and wrinkled skin,) liposuction on her thighs, (to remove unwanted fat deposits,) a breast lift (to lift and reshape the breasts) and, later, a procedure to remove the stains from her teeth. Total downtime for recovery: eight days.

Results? “I stand up straighter, smile more and am in a better mood more often,” says Ellie. “I look good after I get ready for work so the children see a more confident, outgoing mother with higher self-esteem.”

While everybody thinks children are wonderful, not much is said in birth announcements about the physical cost to the mother for bringing bundles of joy into the world. The toll? Stretched and distorted breasts, bulging stomachs, weight gain on the hips – yes, those dreaded saddlebags -- and thicker thighs.

And the damage is not all on the outside. While the uterus is usually about the size of an orange, a baby stretches it against the abdominal wall. As the baby grows and forces the uterus against the inside of the muscle wall of the abdomen, those two vertical muscles (the Rectus Abdominis), the so-called “six pack muscles” get stretched apart and elongate, resulting in a bulge of the lower tummy that cannot be fixed with diet and exercise alone. Once that happens, only surgery can bring the muscles back together again. Moreover, the breasts grow and get larger during breast feeding. After that, the breasts typically decrease, often to a size smaller than before the pregnancy. Result? Stretch marks and hanging breasts. Repeated pregnancies can multiply the damage. But all too often, the toll on the mother’s body is often considered just part and parcel of being a modern mom.

However, no pun intended; many women are no longer taking it lying down. Instead, they are seeing cosmetic and plastic surgeons for what you might call Mommy Makeovers. They just want their old shapes back and many are returning to the world of work where confidence and self-assurance are prized. Commonly requested procedures include tummy tucks and liposuction as well as breast lifts, with or without implants to fill out sagging breasts.

Statistics back up the trend. Women account for 87 percent of cosmetic and plastic surgery patients and underwent some 7.2 million procedures last year, according to the American Society of Plastic Surgeons in Arlington Heights, Illinois.

“The boom in mommy makeovers is accelerated because more women are having children later in life, after they have completed their educations and got a good start in business or the professions,” says plastic surgeon Kim Edward Koger, M.D. in West Palm Beach, Florida. “What I hear time after time from patients is: ‘I don’t want to look like supermodel Cheryl Tiegs, I just want my pre-baby looks back!’” says Dr. Koger who is also an assistant consulting professor of plastic surgery at Duke University.

J.G. (she didn’t want to be identified) of New York City was way ahead on the career track before she tried the mommy track. J.G. worked her way through law school as a chiropractor, started her own very successful law firm in downtown Manhattan and, at 33, gave birth to twins. She ran the firm from home while caring for the twins. By the time she was 37, she had tried most nutritional, exercise and weight loss programs and decided the 35 extra pounds she gained after having the twins would not come off her five-foot-six tall frame through diet and exercise alone. After J.G. read an article about New York City plastic surgeon Mauro C. Romita, M.D., at The Center for Beauty Synergy, she called for a consultation.

“The doctor’s office performed computer imaging which showed what I was likely to look like with that entire tummy gone,” J.G. says. “But my children were delivered by C-section and I did not want any post-op pain again. Recovery from the cosmetic procedure was not bad at all, just a dull ache for a few days.”

The payoff? Thirty-five lost pounds. “For the first time I can remember, I like shopping, have dropped three dress sizes and can fit into a size 8. Plus, I can wear a bathing suit at the beach and not feel like I should be covering up my body.”

The effects of childbirth are so pronounced because, according to Dr. Koger, the human body is more like plastic than rubber. Because the stomach muscles have been stretched, the intestines and other organs push forward into a bay window-like pouch. After those vital muscles are stitched back together and can again do their job properly, the stomach flattens. The procedure requires a hip-to-hip incision but the scar is usually hidden within the bikini line.

“A breast lift is often done at the same time by removing some of the stretched tissue and inserting an implant,” says Dr. Koger. “That helps the breasts to stand up better.”

Pregnancy and weak stomach muscles are often the slippery slope to other bodily woes, like love handles and saddle bags, according to Mauro C. Romita, M.D., a New York City plastic surgeon who specializes in figure restoration programs for new moms.

“One of the benefits of having extra pounds and skin surgically removed is that the appetite is easier to control,” he says. “Fewer fat cells need less insulin, blood sugar is more even, and the appetite not so large. “However, I screen out patients who have high blood pressure, smoke or who have large amounts of overweight.”

Almost everybody associates a rosy, glowing complexion with pregnancy, but the stark reality is that 70 to 80 percent of women in their third trimester go through hormonal upheaval that leads to serious acne and other skin woes.

“Many must also quit taking any medication that prevents acne,” says Manjula Jegasothy, M.D. at the Miami Skin Institute in Miami, Florida. “Many women also have problems with moles until they quit breastfeeding. After that, they can again resume anti-aging remedies like Botox, Restylane and chemical peels.” So Dr. Jegasothy offers an integrated facial program for pregnant patients as soon as they know about their delicate condition. It continues through the finish of breast feeding.”

Says Paul Parker, M.D. a New Jersey plastic surgeon: “Many women feel psychologically affected after childbirth. When they gain weight, many feel undesirable, unmotivated and frustrated, especially if they are working out regularly and still can’t shed those pounds.”

After a woman decides her child bearing days are over, it’s important that she wait four to six months after pregnancy to have plastic surgery. New moms should have time to bond with their newborns -- but most post-op patients are unable to pick up their babies because it puts undue strain on the stitches -- for nearly four to six weeks after the surgery. Plus, the woman’s body should have time to normalize.

“The trend here is for thrilled husbands to spring for the wife’s surgical makeover to show his appreciation,” says Leon Tcheupdjian. M.D., medical director of the Liposuction and Cosmetic Surgery Institute in Chicago which has a special program for mommy makeovers.

But many times, it’s the moms themselves who are the most thrilled.

For instance, remember those children on the train who were mistaken for Ellie Malmin’s grandchildren?

You might like to hear what Ellie’s seven-year-old said after she was totally healed. (Remember, this is a child who sees hundreds of pictures daily of actresses, pampered celebrities, bathing beauties and top models on TV, in movies and magazines.)

“Mommy! You look really good!”



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