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Stretch Marks? Meet the "Mommy Makeover"

Posted 10 January 2013 by Guest Blogger

by Michael J. Yoo, M.D.

Pregnancy is a remarkable period in a woman's life as her body prepares to bring a child into this world. But the physical changes, like weight gain and stretch marks, that occur during pregnancy and with breastfeeding can linger and be a cause for persistent concern to the mother. Why is pregnancy a natural "tissue expander?" And what can be done to treat these problems? From the skin to the breasts, let's explore some science.

During pregnancy, the growing child requires more and more room within the mother's womb, or uterus. The uterus expands as the child grows, and in turn expands the belly and the overlying skin. At the same time, the breasts begin to swell in preparation for milk production and breast feeding.

Skin, the largest organ in the human body, is intrinsically elastic and can stretch to a certain limit. Up to this limit, constant stretch, as occurs during pregnancy, creates more skin. Beyond this limit, "stretch marks" occur and represent an irreversible breakage of dermal elements (natural constituents within the skin). The degree to which stretch marks occur varies from person to person, depending on their individual skin quality and genetics.

Of course, like all elastic substances, there is some "recoil" of the stretch of skin after the stretching force (i.e. pregnancy and breast feeding) is gone. The degree to which the skin returns to its pre-pregnancy state also varies. Most often, women after childbirth are left with at least some excess skin in the lower abdomen with or without stretch marks. Moreover, the breasts, which swelled during breast feeding, appear "˜deflated' and droopy (ptotic) because their internal supporting structures (Cooper's Ligaments) have also been stretched beyond their limit. These changes can be exacerbated by multiple pregnancies and childbirths.

The "˜extra' skin, stretch marks and overall "˜deflated' appearance of the abdomen and breasts cannot be eliminated by exercise. In fact, there is no amount of exercise that can correct this appearance. Remember, exercise and weight loss decrease fat content, they have no direct effect on the quantity of excess skin. To the contrary, losing weight (i.e., fat) serves to "˜deflate' the skin even more, worsening the appearance of excess skin and the droopiness of the lower belly and breasts.

To eliminate this excess skin and correct its droopy appearance, the skin must be surgically excised and re-tailored to conform naturally to the underlying tissue. An abdominoplasty or "˜tummy tuck' involves excising the excess skin and fat of the lower abdomen. It also involves bringing together the rectus fascia (the tissue covering over the rectus or "˜6-pack' of abdominal muscles).

Remember, everything about the belly stretches during pregnancy, and this includes the muscle and its coverings. The stretched rectus fascia, which is brought back together by sutures, acts as a "˜natural corset' and narrows the waistline. Finally, selective liposuction of the flanks and hips can further enhance the result in the right candidate. The overall result is a flatter, more attractive tummy with a fine line scar that can be hidden within the bikini line. The surgery is itself outpatient, and all patients are able to walk the same day.

A breast lift (Mastopexy) is the procedure used to reshape the "˜droopy' and sagging appearance of the breasts following pregnancy and breast feeding. Excess skin is removed, and the remaining skin envelope is tailored to drape aesthetically to the underlying breast tissue. The nipple, which often appears to be hanging on the lower pole of the breast, is "˜lifted' to a more natural and aesthetically pleasing position. A breast lift does not actually make the breast larger, but sometimes the reshaping does provide an illusion of greater size. In order to add more volume, some patients choose a simultaneous augmentation with a silicone or saline implant that can make the breasts appear even fuller and larger. A breast lift with or without augmentation is an outpatient procedure, and patients are again asked to walk on the same day as surgery.

There are a variety of modifications to the procedures described above which can be selected according to the individual patient's physical characteristics and goals. Please feel free to comment on this post with any questions, or contact my office to schedule a consultation. Thanks for reading.

 src=Michael J. Yoo, M.D.
Assistant Professor of Plastic & Reconstructive Surgery
Summa Health System
Akron, Ohio


  • judy moore said: 1/11/2013 12:41 PM

    Is there anything that can be done for stretch marks? My daughter, who was diagnosed with Myasthenia Gravis in 2006, has terrible stretch marks from her knees up/abdomen/and arms from elbows up. She was on Prednisone which made her gain about 60lbs in a very short time. She even had some of the stretch marks break open and bleed.The weight mostly came off, but she was left with the deep, wide stretch marks. She's tried different creams, but I was wondering if there were any treatments for this. Thanks! ~Judy

  • Summa Flourish said: 1/11/2013 5:05 PM

    Hi Judy - First, I'm sorry to hear that your daughter is coping with this. There are a lot of different opinions on the treatment of stretch marks when it comes to non-surgical remedies. As far as I know, there aren't any scientifically or medically proven creams or medicines to improve the appearance of stretch marks once they have occurred. Stretch marks occur when the skin is stretched beyond its limit (that limit being different for different individuals). Stretch marks are an irreversible breakage of dermal constituents of skin - meaning they are permanent. While they can never be completely eliminated non-surgically - they can improve in appearance over the course of time. Rapid increases in weight such as what can occur with steroid use can cause obvious stretch marks that are purple and deep. Over time, this usually improves as the color fades. The time frame for this varies from person to person. Unfortunately, the stretch mark, however, will always be there. A stretch mark is in essence an injury underneath the skin. Your body can heal it to a certain degree, but like a scar or wound on top of the skin, it will always leave a permanent mark. Steroid use is invaluable in the treatment of certain medical conditions. It has a number of side effects, however, including weight gain. It also can impair the body's ability to heal itself and this can cause wider and more purplish stretch marks. Did this help to answer your question? Michael J. Yoo, M.D.

  • Judy Moore said: 1/16/2013 8:49 AM

    Thanks for answering, Dr Yoo. I appreciate the information you gave. ~Judy

  • Grace a said: 2/27/2014 2:01 PM

    I have lost A LOT of weight over the past year by seriously improving my eating habits, working out three times a week, and oh yeah...pushing a 9 pound baby out my body! I lost 60 pounds which was great but my stretch marks actually got worse! I have tried a few different products and found the Somatique Stretch Mark Cream to be one of the most effective for the price. Its from Lady Somas website. I also found that by massaging their stretch mark cream into my tummy it makes my skin feel so much softer and smooth. I would totaly recommend this too along with the somatique moisturizer. Just these two things has simply been the best thing I've done for lessening the appearance of any stretch marks. I noticed results within the first month, skin is much more smooth and firm.

  • Cosmetic Surgery at Brisbane Cosmetic Clinic said: 7/24/2014 5:36 AM

    Women should take care of their bodies even after having children. That's the best gift they can give to themselves, their husband and their children. Great post!

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