Tummy tuck surgery is one of the most commonly requested and satisfying of all the body contouring procedures. While it is has many potential issues including scar length and recovery, it is often the only way to significantly change the waistline and abdominal shape for many women. Some women make valiant efforts with diet and exercise regimens but find that they eventually ‘hit the wall’ and then appear for a tummy tuck consultation.
A tummy tuck works because it removes excess skin and fat from around the waistline, resulting in a flatter abdomen and a less round waistline. But because of the scar and the muscle tightening, it is always a good question how a future pregnancy may affect the result. Because a tummy tuck is a pure cosmetic procedure that only affects what lies outside the abdominal muscle layer, it has no effect on the ability to get pregnant. It is always advised to wait to have a tummy tuck after one is certain they are done having children. But it is not rare to have a woman get pregnant after having a tummy tuck even though they may be certain beforehand that their child creation days are over.
So it is not a question of whether one can get pregnant after having a tummy tuck but whether the pregnancy will affect the positive changes that the tummy tuck created. While every woman is different, suffice it to say that pregnancy following a tummy tuck will adversely affect some of its cosmetic benefits. The skin and the muscles will expand with the pregnancy, it is just a question of how much and whether the tissues have good recoil (shrink back down) afterwards.
One common observation that women report is that becoming pregnant again after a tummy tuck results in a much later show than in their earlier pregnancies. This would be expected since both the overlying skin and the underlying muscles are tighter than ever before. But the expanding baby will, by slow and continuous pressure (like a tissue expander), stretch out to accommodate its need for space. This will create some muscle and skin looseness that does effect the tummy tuck results after delivery. Depending upon how large one gets, most post-pregnancy tummy tucks will desire to have some retightening or ‘touch-ups’ to regain their pre-pregnancy tummy tuck form. Often this may be more of a mini tummy tuck approach or even simple skin removal along the old scar line.
The timing for a secondary tummy tuck after pregnancy would be the same as with an initial tummy tuck after pregnancy. Wait until all the tissues have shrunken down and the baby fat is lost. This is usually at least three months after delivery and six months is more ideal for some women.
In a contrarian approach, I have done four cases of tummy tuck revisions at the same time of delivery as requested by the patients. Their point was that they were already on the operating room table and knew that they would have some skin excess. They all were going to have c-sections through their old tummy tuck scar anyway. This seemed like a good time to them to address any abdominal excesses. While you can not tighten the abdominal muscles due to the size of the uterus, residual abdominal skin can be safely removed as part of the c-section closure.
Dr. Barry Eppley
Indianapolis, Indiana