Pregnancy After Abdominoplasty Surgery

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Beth Longware Duff, Medical Editor

Beth Longware Duff is an experienced writer and reporter whose work on a wide variety of topics has been published in numerous newspapers and magazines. Her health and medical writing credits include nationally distributed videos for the March of Dimes Birth Defects Foundation, and she is the recipient of numerous awards including an American Cancer Society Media Award and a New England Press Association Award for Health Reporting. She holds a degree in Communications from Ithaca College.


August 04 2008

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Pregnancy after Tummy Tuck
Women who undergo a tummy tuck to regain their figure after childbearing or a major weight loss should do so with the understanding that any future pregnancies could undo all the improvements that were realized in the operating room. But even the best laid plans can change, and some women do become pregnant after abdominoplasty (the medical term for a tummy tuck). For some it's a cause for concern, but the good news is abdominoplasty does not rule out future pregnancies, nor does it generally compromise the developing fetus.

Simply put, abdominoplasty involves the surgical removal of excess skin and fat from the middle and lower abdomen, as well as abdominal muscle repair when needed. It does not involve the reproductive organs, or any other organs inside the abdomen, for that matter. The result is a flatter tummy and smaller waist. Scars are usually confined to the area covered by a swimsuit bottom or underwear. Other scars, including those resulting from a Cesarean delivery and stretch marks, can often be removed or improved during a tummy tuck.

During pregnancy, this same abdominal area stretches as the fetus develops. Vertical muscles that were tightened during surgery (a procedure referred to as plication) can stretch apart again, and abdominal skin may not be elastic enough to return to its normal state once the baby is delivered. If this happens, additional surgery called a tummy tuck revision may be needed. That's why most plastic surgeons recommend that women complete their childbearing before having a tummy tuck. If that's not possible, they advise patients to wait 6 months to a year or more after surgery to maximize the healing process before trying to get pregnant.

Patrick Nugent, MD, Chairman of the Department of Obstetrics and Gynecology at Norwalk Hospital in Connecticut, agrees with that advice, adding that it also applies to women interested in breast augmentation, reduction, or a breast lift, which are often combined with a tummy tuck for a mommy makeover. He adds that pregnancy after abdominoplasty could become complicated if the patient requires a scheduled or emergency Cesarean section, which account for nearly one-third of all births in the United States. "It depends on what type of tummy tuck they've had and how extensive it was," he explains. "Any time you have surgery you're going to have scarring, and that makes it trickier to get in there to get the baby out." Scarring would not be an issue in a vaginal delivery, he adds.

Can Tummy Tuck Surgery Before Pregnancy Affect the Fetus?
Most risks associated with pregnancy after a tummy tuck are theoretical in nature. For example, if there is not enough room for the uterus to fully expand, fetal growth could be compromised. If complications arise with the baby, a Cesarean delivery may be indicated. If you do find yourself pregnant after abdominoplasty, you should tell your plastic surgeon and obstetrician so all three of you can work together to carefully monitor the pregnancy.

"The obstetrician would probably want to read the plastic surgeon's notes on the surgery about how the tummy tuck was done so he or she knows how to proceed," notes Dr. Nugent.
If the tummy tuck included surgical repair of the vertical rectus abdominis muscles ("abs"), this area could become sore during the pregnancy. It's also likely that the muscles will be damaged, requiring a later revision. As Dr. Nugent points out, "A lot of that good cosmetic surgery is going to be put under major stress."

Some women who have become pregnant after abdominoplasty have noticed that they don't "show" as early in the pregnancy. This may be because of the tighter abdominal muscles and skin. Just as the muscles stretch to accommodate the baby, so will the skin.

Whether or not a woman has any complications related to abdominoplasty during her pregnancy or delivery, there is no guarantee that she'll be able to maintain the results of the surgery afterwards. A revision is always a possibility. The best way to ensure that the results of a tummy tuck last for years to come is to plan ahead and hold off on surgery until your family is complete.

"I encourage my patients to wait until they're sure they're done childbearing before having any abdominoplasty or cosmetic breast surgery," says Dr. Nugent. "Cosmetic surgery has risks and benefits, so you only want to do it once so it serves it purpose."