The problem that some of us have is that once the babies are here the weight never goes back to normal despite breast feeding which result in a relative large excess of Lower belly fullness. This is only partly due to the excess subcutaneous tissue. The other part is related to the stretched abdominal wall fascia and separation of the abdominal musculature in the center, called a “diastasis”. Other mothers of multiples and very thin mothers of singletons have a slightly different but equally annoying problem where they go right back to their prepregnancy weight and the muscles align themselves perfectly back to the midline so their tummy is flat as a board, but it is dressed with floppy, wrinkly skin full of stretch marks. Both problems are solved by an abdominoplasty.
The goal of this procedure is to remove the redundant skin and tighten up the abdominal wall fascia, if necessary. After having multiples the fascia us usually always tightened. Usually all of the tissue below the belly button is removed and the skin and soft tissue above the belly button is stretched down to the area just above the pubic hair. The scar extends across the pubic hair and towards the hips and is kept in the bikini line. Patients are encouraged to bring in their favorite cut bikini or bathing suit or undies to be sure the markings are correct. The belly button is brought out through a new hole in the same place where it was before the surgery. The surgery is realty wonderful because it allows the person to regain a nice flat belly and many people who never thought they would go back to a bikini, actually do!
The post operative course is not bad for most people. Most people use a narcotic and prescription dose Advil (Ibuprophen 800 mg) for 5-10 days. By 10 days just about every one is up and about. Drains are needed and remain in place until the drainage is small. This is different for each patient.
The other problems that result post – delivery are either complete loss of breast tissue, called involution, or enlargement of breast tissue or simply flopping of the breast. All of the procedures are also wonderfully rewarding for the patients. The breast reduction is the only procedure which is covered by insurance if the reduction is Large enough. The definition of large enough is different for each insurance company, so a consult is a must, in order to attempt to get insurance coverage. Patient’s who have Lost their breast tissue or the breast have simply “gone south” are candidates for one of three procedures. Augmentation mammoplasty, (breast augmentation with implants) , mastopexy ( breast lift with no implants) or a combination of the two. The decision as to which is best is largely determined by two factors: 1. Is there enough breast tissue when in a bra to simply remove excess skin; and 2. Are the nipple areolar complexes in the correct position. The goal of all of these surgeries on the breast is to create a breast which looks Like a teenager’s breast again. Therefore all of the parts of the breast are evaluated to determine which procedure would accomplish that goal.
I hope that you have found this informative and helpful. If you would like to come in to discuss any of these or any other issues in more detail, please call the office and let them know you are a mother of multiples and the $150.00 consultation fee will be waived. 781-235-1007. Also feel free to check out our web site at: www.osullivanptasticsurgery.corn
By: Kimberly O’Sullivan-Hall
(Plastic Surgeon)
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