POST PREGNANCY PLASTIC SURGERY IN SYDNEY
Children bring us joy, they are the future and born out of love. Their arrival often comes as an earthquake of sorts to otherwise relatively ordered lives, I know I am a parent. Once we find our feet, with Sydney mothers especially having to cope with sleep deprivation and routines, life takes semblance of order and family planning is complete. However, despite exercise and a healthy diet, there are tell tales of the journey. These range from abdominal stretch marks, hernias, separation of muscles to a changed in body habitus and shape. Breasts, especially in breast feeding mothers can show signs of deflation and sagging following this period.
A combined abdominoplasty and breast lift is a surgery that seeks to address these changes and to alleviate them. These are concentrated chiefly on the breasts and the abdomen. The surgery on the abdominal wall can be as little as a mini abdominoplasty to a full or expended abdominoplasty with or without liposculpture. The breast surgery can range from a simple breast augmentation, a breast lift or a combined breast lift and breast augmentation. Judicious injection of fat may be utilised for the breasts depending on the each case.
The lower abdominal segment stretches especially in the final trimester. This includes a vertical as well as a horizontal axis of contribution. The skin, the fat and the underlying muscles are all involved to varying extent. Following birth, much of these stretched out tissues return towards their original dimensions, although some redundancy often remains. Any surgery will have to take into consideration not only the excess skin but the laxity of the muscles and the separation of the recti ( 6 pack muscles) from each other. Measuring approximately 6-9 cm from the top the vagina there are landmarks to ensure that proportions and positions of anatomical sites are not distorted. The upper incision is often just above the umbilicus (bellybutton). The skin once separated from the underlying muscle gives access to the rectus muscle. The edges of the muscle and its covering sheet can be seen and are sutured together with a permanent suture. With the external intra-abdominal pressure (baby) having left to enter this world the rectus can now sit without force in its normal resting place. The skin is undermined all the way to the ribcage in the midline and on the sides. The skin is now re-draped the wounds are closed often over drains and the belly button is brought through the skin on the correct site.
For the breasts the surgery can be as simple as an implant augmentation to make up for the deflated volume, or they may require a lift or in some cases lift and augmentation with implants and/or fat injection. We will discuss this in the next blogs.
RECOVERY AFTER SURGERY
The postoperative course is fairly predictable, with 1-2 nights in hospital following surgery in my practice (either Sydney or Canberra) and then discharge. Mobilisation in the early postoperative period is well documented to require subsequent use of pain relief medications meaning pain is resolved faster. Most patients are mobile and back to many of their normal tasks in Sydney within 10 days. We have a postoperative recovery regime that highlights all these steps.
