bodypostbaby's blog

Obstetrics and Gynecology, Feb 2010 published a study out of Norway looking at exercise, BMI, and baby birth weight.

Findings?

They looked at 43000+ women aged 15-49 who were pregnant with a single fetus.  The women’s exercise was walking jogging, biking, weight training, aerobics, etc.  They averaged 6 times a month for the first half of pregnancy, and then once a week until week 30. 

The average weight of the infants at birth was 3,677 grams (8 pounds. Ouch!), and those who exercised during pregnancy did not have a significant effect on birth weight.

BUT, they did find an association with BMI. 

What is BMI? BMI is body mass index, to do it in US measurements, it is 703 x weight (lb)/ height (inches) squared.  BMI 18.5-23.9 is normal, 24-29.9 is overweight, and greater than 30 is obese.

The prepregnancy average BMI of the women in the study was 24. Fleten’s team found each unit increase in the mother’s BMI was associated with 20 grams (0.70 ounces) heavier birth weight.  So an increase in BMI of 5 units — 29 versus 24 — would cause a birth weight increase of 103 grams (3.63 ounces).

The Norwegian doctors suggest doctors focus on preventing or treating overweight and obese women of childbearing age to help reduce the risk of giving birth to babies who weigh too much. (OUCH!)

SOURCE: Obstetrics and Gynecology, February 2010

Short answer: Yes. You can get pregnant after a tummy tuck.  That being said, every plastic surgeon you meet will tell you to tuck after babies.  Why?

Well, what makes you want to get a tummy tuck now? You are likely

stretched out,

hanging or loose skin, 

loosened muscles,

and maybe stretch marks. 

When we do a tummy tuck we 1. tighten the muscles and 2. tighten the skin.  Another pregnancy will do the opposite.  Your muscles and skin will stretch to accomodate the pregnancy.  Your internal stitches to tighten the muscles will likely loosen or rip.  Your skin will stretch  and if you are prone to stretch marks, you will likely form new ones

STORYTIME:

 I had a patient who had major weight loss. 100 pounds.  She came to me for a tummy tuck.  She also was 30 ish, and when I asked, she said she wanted children in the future.  She was a great tummy tuck candidate- she had horrible stretch marks and hanging skin.  But I told her to wait.  Why? She is 30.  She can’t wait too long to have kids due to that darn fertility time clock.  She formed bad stretch marks from her weight gain.  People who form bad stretch marks tend to do it again.  The stretch marks now are mostly on her lower belly, and I will remove them when I tummy tuck her.  If I tuck her now and tighten the skin, when she gets pregnant she will form new stretch marks.  These stretch marks will go where she stretches, which includes above the belly button.  I most likely won’t be able to cut these out after her pregnancy.

IF she waits, she is “prestretched” for her pregnancy (from her prior 100 pounds of weight.) She will likely look just like she does now after the baby.  I can then tuck her after the baby, and likely get rid of her stretch marks.  It is also one less surgery. 

 And, something doctors don’t talk about, but being pregnant can be tough.  Watching your flat belly stretch… and stretch…and stretch is hard to do.  When you”fixed” your belly with a tummy tuck and your new pregnancy and baby is now “ruining” it – that is not a good dynamic.

If life throws you a curve ball, then it happens.  But if you are planning things out, think of your body for the long haul- what will be the best result 10 years down the road.

I was recently the featured interview for an online magazine for busy moms to talk about the mommy makeover.

http://bizymoms.com/palo-alto/surgery/mommy-makeover-palo-alto.php

So you are going to take the plunge. I think it is fantastic.  There is nothing I have done as moving and rewarding as having children.  Pregnancy is hard on the body.  Common changes occur.  Here is a brief overview of some things to do before you get knocked up.

1. Exercise.  A healthy body does better with pregnancy.  A lot of the women I see with great figures after pregnancy had them before pregnancy.  So improve your muscle tone, particularly your core muscles (especially the rectus muscles and oblique muscles which you use to do pilates/the plank/sit ups). 

2. Healthy skin.  The “rosy skin” of pregnancy sounds great. And many women do get it.  They also get a lot of pigmentation.  The sun spots, age spots, freckling- call it what you will- worsens with pregnancy.  So prior to pregnancy, try to reverse any skin pigmentation you have.  Hydroquinone and Retin A are great for pigmentation, but they are NOT baby safe.  There are products with Vitamin C and E which are okay while pregnant and breast feeding.  And the key to pigment? SUNSCREEN and the big floppy sun hat. You should apply sunscreen daily.  Try to find a moisturizer or makeup base with sunscreen in it.  When doing activities in the sun, apply sunscreen 20 minutes before going outside, reapply every 45 minutes in water, reapply every 2 hours regardless, and use sunscreen less than a year old.  I am a fan of the clear zinc based sunscreens.  They are mechanical blockers, not chemical, so they are likely less absorbed in the skin.  Very effective and thought to be a little more baby safe.

3. Ideal weight.  You will gain weight with pregnancy.  (Oh my!? shocking.) The amount of weight you gain varies, but the usual recommendation is 25 pounds.  There is a correlation with weight gain and body changes- stretch marks, loose skin, diastasis, and higher post pregnancy weight.  There are studies which link obese children to mothers who were obese before pregnancy.  (The amount of weight gain has been revised to 11-20 pounds for women with a BMI of 30 or more.) 

4. Stop smoking.  I could go on for ages on this one.  It affects every body system; increases your chance of heart attacks, stroke, and cancer; along with sun exposure it is the biggest ager of the skin, and does things I can’t fix with products and peels; no surgeon will do a tummy tuck or a breast lift on a smoker, so you might as well stop now; it is expensive; you can’t do it in restaurants; it yellows your teeth. 

The health effects on the baby: it lowers the amount of oxygen they get in utero, increases heart rate, and increases rate of miscarriage and low birth weight.  There are other studies indicating after birth these babies have issues with asthma, behaviorial issues, and higher SIDS. For more information go to: http://cerhr.niehs.nih.gov/common/smoking.html. 

5. Surgeries. The one surgery I like before pregnancy is liposuction.  If you have a discrete problem area, like “my outer thighs,” or are an exaggerated pear or apple shape, your shape will not improve with pregnancy.  Particularly for those women who are teeny tiny up top and carry all their weight in their thighs/hips, when you put on baby weight it will all go there.  Fast forward: you are now 10 years older and have stretched that skin more, for a longer time, and your skin is older- it won’t bounce back after liposuction like it would at age 25. Skin tone is key to liposuction, and young skin is better.

I do not like to do abdominoplasty (tummy tuck) or breast surgery right before babies.  If your breasts really bother you and you will not have babies for 5-10 years, then it may be worth it to do now. But pregnancy and breast feeding affect the belly and the breast the most.  If you can, wait to fix up those areas until after you have kids. 

So,

Exercise. Wear sunscreen. Eat well/be your ideal weight. Don’t smoke.  Sounds simple, eh?

Now go get practicing to have that baby.