By: Dr. Leppink
“I do sit ups all the time but I can’t get my tummy flat again after my pregnancy!”
We hear this statement all the time from our frustrated post-pregnancy patients, and unfortunately they are right! The changes that occur in a woman’s body during pregnancy can very seldom be improved with even the most strenuous exercise program. The problem is that a woman’s anatomy changes during pregnancy and exercise cannot change your anatomy.
Firstly, during pregnancy there are hormones released that “soften” the skin and support tissues in your body. The “softening” allows skin and the supporting tissues, sometimes called fascia, to stretch to allow space for the baby to grow and prepare the pelvis bones to separate during delivery. The sensitivity to these hormones can be so great that the skin can literally “tear” from the inside out, resulting in a “stretch mark.” These “tears” cannot be corrected with exercise or topical creams. Secondly, the supporting tissues that hold the abdominal muscles together can also stretch. This can cause the muscles to separate from each other, allowing your insides to “bulge” out. Sit-ups and “crunches” can make your muscles stronger, but cannot tighten the stretched tissue between the muscles. The way to restore a pre-pregnancy contour to the abdomen involves correcting these two problems.
The correction is a surgical procedure commonly referred to as a “Tummy Tuck” or Abdominoplasty. This procedure includes suturing together the abdominal muscles and then removing excess skin. The stretched tissue between the muscles is pushed down into the inside of the abdomen, and the muscles are then sutured together with permanent sutures. After the muscle repair is accomplished the patient is positioned in a slightly flexed position and the extra skin is removed and the incisions are closed. The procedure restores a patient’s core muscles to their pre-pregnancy position, but does not affect the abdominal muscle strength or function once recovery is complete. So ultimately the goal of a “Tummy-tuck” or Abdominoplasty is to repair the separated muscle and remove extra, stretched out skin, which returns a woman’s abdomen to her pre-pregnancy contour!
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