Calling All Hard-Working, Gym-Doting Mothers

How many post-pregnant women exhaust themselves at the gym only to find that their "love handles" or other abdominal problem spots just keep getting worse? Board Certified Maryland Plastic Surgeon Dr. Donald Kress, helps these women eradicate the "Mommy Tummy" by performing "abdominoplasty" or tummy tuck as it is more commonly known.

Most mothers come to Dr. Kress with the following complaints:

1. Stretch marks of the abdomen following the birth of their children
2. Laxity of the skin of the abdomen
3. Reduced ability to do certain yoga and floor exercised involving abdominal strength including simple sit-ups
4. Unsightly bulging of her abdomen when she does do sit-ups and other exercises to the point that leads to severe embarrassment.
5. Progressive increase in her waist size despite intense exercise

One such 33-year-old mother of two children had serious problems with her post pregnancy that interfered with her ability to exercise and her physical appearance. The most frustrating thing to her was that increasing her activity seemed to be exacerbating the two most significant conditions: that of the bulging abdomen and the increasing size of her waist.

Bulging Abdomen:

The two most powerful muscles of the abdomen are the rectus muscles, which form the muscle group commonly known as the six-pack and provide the power necessary for balancing the back muscles and activities such as sit-ups and many of the Yoga and advanced floor exercises. These muscles are frequently separated down the middle by pregnancy, especially if the mother is small or the baby is large. Once these muscles separate in the middle (linea alba) this is known as "diastasis recti". This is the beginning of the problem. This separation, which is actually a form of hernia, gets progressively worse with increasing exercise and the bulge grows. Additional exercise, instead of correcting the problem surgically, just increases the gap in the muscles and the overall problem.

Increasing Size of the Waist:

Another set of muscles which can assist in some of the function of the rectus muscles are the obliques - they are further to the side but can do some of the same function. With continued exercise of the ineffective rectus muscles, the obliques begin to gain in strength and volume. The eventual result is a larger waist, a muscular imbalance, and a "freakish" look to the abdomen.

Procedure
The tummy tuck procedure is done under general anesthesia, requires 2 to 3 hours, and will take about 2 weeks to get back to work. Two small punctures are made in the lower abdomen for insertion of a very small injection cannula. Through this cannula a mixture of saline and a tiny dose of adrenaline is instilled to swell the fat cells, reduce the size of the blood vessels, and make the procedure easier. After the fat cells are swollen, liposuction is then done on the flanks and the upper abdomen. When sufficient fat is removed, and this can be very little in thin individuals, the incision is made across the lower abdomen respecting the natural landmarks and the pattern of the pubic hair.

The incision, which is on the surface of the muscles, not invading them, is carefully extended toward the head until the umbilicus is reached. The umbilicus is detached from the abdominal wall, and a small tunnel is made up the center of the abdomen. Once this has been accomplished, permanent soft sutures that pull the edges back together in the midline bring the widened rectus muscles back together. Two small plastic tubes are placed beneath the flap and attached to suction devices to eliminate bruising and extra swelling.

The remainder of the procedure consists of pulling down all of the excess abdominal skin (usually containing the stretch marks) and trimming that off. The belly button is reattached in its new location and the wounds are all closed. There are no sutures that have to be removed. The patient is placed in an abdominal elastic binder, and the drains attached to suction. Patients can return home after about 2 hours of in office recovery.

Dr. Kress’ Patient
She had her procedure performed about one year ago and she couldn’t be happier. More than 90% of her stretch marks are gone. The laxity and looseness of her abdomen is resolved, and the scar is barely visible. The color and texture of the scar is excellent just like the surrounding skin. And most importantly, no bulging no matter how strenuous the exercise routine, and her waist is almost back to its pre-pregnancy size.

More information can be found on the Web at www.plasticsurgeryone.com. For more information or an interview with Dr. Kress and his patient, please contact Meghan Berger at 212-213-6444 ext. 17 or meghan@kmrcommunications.com