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Tummy-tuck immediately after c-section? Not recommended!

28Sep

For the past several weeks I have been watching people on facebook and the media taking sound bites from both Mitt Romney and Barack Obama and using them completely out of context.  Today, I have a new appreciation for their frustration.

I was just given a copy of Star magazine in which I was quoted regarding Tori Spelling’s recent hospitalization.  Her public relations manager states she was admitted to the hospital with complications three weeks out from a c-section.   A reporter for Star magazine had “inside information” that she was having a tummy tuck.  I was quoted as saying that it is physically possible to have the procedure, but I never intended to give the impression that it was “perfectly safe” to do so.  In fact, I stated it was not recommended.

Safety is a significant concern and there are physiologic changes that occur with pregnancy that would make a tummy tuck (abdominoplasty) even more risky immediately after having a child.  These include vascular changes that would increase the risks of bleeding and more importantly, deep venous thrombosis or DVT, which is always a concern with abdominoplasty even in the best of circumstances.  The risk for blood clots is elevated 4 times normal during pregnancy but even higher in the few months following delivery.  The risk of pulmonary embolism is actually 15 times higher.  This is not the time to have an elective surgery that would further increase your risk of this serious complication.

There are significant hormonal effects that persist after pregnancy that can lessen the strength of the abdominal muscle repair, and your body needs time to adjust to the changes in blood volume from pregnancy and any blood loss from delivery.

Another reason to wait before undergoing abdominoplasty is that after having a baby, your attention should be directed at the baby, and not recovery from an elective cosmetic surgery (or dealing with a complication). If you are breast feeding, you would have to stop (at least for a while) as anesthesia and medications can be passed through breast milk. It is best to wait until after breast feeding.

Would your results be any better by waiting?  Yes.  Reducing your body weight to near ideal will allow more skin to be removed or the scar to be lower (better hidden under your bikini line).  Liposuction could be better targeted.  Waiting for your uterus to shrink back to normal will allow a tighter abdominal wall repair, and a tighter tummy.

It is important to understand that an abdominoplasty should be done only after you are done having children.  It is not a surgery easily repeated.

Most plastic surgeons, my self included, will recommend waiting at least 6 months from delivery.  My patients will tell you that I always have a long discussion regarding risks and potential complications of surgery, and not everyone is a good candidate.  I never say that any surgical procedure is “perfectly safe” but, with careful timing and preoperative optimization, those risks can be minimized and results maximized.  If you are considering a tummy tuck, seek out a surgeon certified by the American Board of Plastic Surgery.

Abdominoplasty is one of my favorite operations because the improvement can be so dramatic.  My patients can’t say enough about how much better they look and feel after the procedure.  Is it possible, as Star Magazine suggests, that Tori Spelling had a tummy tuck 3 weeks after a c-section?  Technically, it could be done, and every situation has its own circumstances.  I personally think it unlikely.  Regardless of  the reason for her hospitalization, I wish her well and a speedy recovery.

Would I have done an abdominoplasty on Tori Spelling three weeks after a c-section? In a word – NO.

Dr. Aguiar

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