Many women gain weight after pregnancy because they had to feed their baby in utero and they were subjected to a lot of hormonal variations during this pregnancy.
Excess of weight after pregnancy is not always easy to loose and the extra-amount of weight gained during pregnancy varies enormously among women. Some women will gain 5 kilos, some women will gain 30 kilos.
It depends also of the cultures and the region the woman is living.
In France we recommend to gain only 10 kilos during the pregnancy but most of the women will gain 13 to 15 kilos and of course some women might gain 30 kilos.
The excess of weight damages the skin. It is stretching the skin and breaks the conjonctive tissue connection, and also causes physiological disturbances as excess of sugar in the blood or high-blood pressure during pregnancy which may stay after pregnancy.
So my advice is to control the weight during pregnancy, a consultation at 3 months pregnancy so we can planify with the gynecologist and then of course help the woman after delivery to have a more appropriate diet especially if she is breastfeeding.
After 4 or 6 months we can easily think about liposuction and we will wait generally 6 months after delivery to talk about tummytuck, especially if the woman had two or three children and does not wish any new baby. This is the perfect procedure to regain a flat abdomen.
Then of course we will treat the breast only after breastfeeding. Breast alteration might be hypoplasy and ptotic breast. The breast is sagging and is empty especially after long breastfeeding (more than 6 months) and many times it means that we will have to reshape the breast on a breast prothesis or if the sagging is not excessive we might propose a breast lipofilling : it means fat transfer to the breast taken from another part of the body, which gives also good result in terms of moderate augmentation.
Body-reshaping is not so difficult but we need a woman motivated and a clear planified action. It means diet, gymnastic and sport and of some planified aesthetic procedures like liposuction are definitely helping. The stretchmarks occur during pregnancy and are caused by the excessive stretching of the dermal tissue and it’s really difficult to treat. It can be prevented by applying a specific cream, controlling the weight gain during pregnancy.
The treatment of these stretchmarks is difficult. We might use radiofrequency, peeling, micro-dermabrasion and mesotherapy. In my hand, at least with my experience, the most efficient are mesotherapy with micro-dermabrasion. Mesotherapy needs to contend stem cells , activated growth factors and hyaluronic acid at least.
The tummytuck after multiple pregnancies is most of the time needed. The abdomen is sagging, the muscles are too parted away and the woman can’t tighten her muscles.
Typically, push-ups during gymnastic are not efficient.
We do a liposuction before to remove some fat of the abdomen and then a supra-pubic incision then uncleave the abdominal skin and underlying fat reaching to the muscles. The muscles will be tighten to give tonicity to the abdomen, then the excess of skin and fat are removed by excision. If there is any real hernia it will be treated in the same time.
Then finally we reposition the umbilicus or do a plasty of the umbilicus. The final result is very rewarding and is well-accepted. The scar just needs to be well-positioned. An extended abdominoplasty will include a lateral thigh-lift.
A high lateral tension abdominoplasty tighten abdominal muscles in vertical line.
The interest of this technic even more is good definition of the abdominal wall.
The result will end-up with a flat abdomen with better defined waist-line.
Genital Repair might be also needed.
I can tighten the vagina, repair muscles deficiency, reshape the opening of the vulva, give shape and tonicity to outer majora and inner small labia so the woman feels young again. It is also enhancing the sex life of the couple which is great after pregnancies.