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April 18 2014

styledotcom Susan Sontag was a force of personality and brainpower. We chat with the director about her new doc: stylem.ag/Ql6kS4 @donetodeath

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A Post-Baby Belly Like Gisele’s

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Gisele post-babyThis column features weekly tips and advice from a revolving cast of industry leaders on hand to discuss your beauty dilemmas, from blemishes to Botox.

I have persistent belly fat that I just can’t seem to lose post-baby. I used to love wearing body-conscious dresses, but now I’m self-conscious about my pouch. What can be done to get rid of it?

This is how I start the conversation when a woman comes in about her post-baby “pouch”: The abdominal wall is made up of three layers—skin, fat, and the deep abdominal wall (usually referred to as “muscle,” but the thing that is corrected here is actually the tissue connecting the muscles together, not the muscle itself). The appropriate procedure for you depends on which layer it is that needs adjustment, and can range from a small amount of liposuction under local anesthesia to a full tummy tuck (abdominoplasty).

If you want to get a general idea of what is going to work for you—or just brace yourself—you can do this self-examination before you head in for a consultation with a plastic surgeon:

Stand sideways in front of the mirror and totally relax your stomach muscles. If you balloon out, post-pregnancy stretching and weakness of the deep abdominal wall is at least part of the issue. You probably also find that your stomach sticks out more at the end of the day than when you first wake up, or that you feel like you still look pregnant. Unfortunately, no amount of sit-ups, Pilates, or core exercise is going to fix this problem. If you want your stomach to be flat again, you will need a surgical repair with internal sutures that pulls the muscles closer together, like an internal girdle. This is part of the tummy-tuck procedure and is done through a low incision that is hidden below your underwear line.

If your deep abdominal wall is stretched out, chances are so is your skin. Stretch marks are an obvious indication of this, but if you can easily grab the skin between your belly button and your underwear line, this is another way to tell that you probably need at least a mini tummy tuck, which can be as minimal as removal of the extra skin through a low, hidden incision that is usually shorter than the one for the full tummy tuck.

The fat layer itself is usually not the issue post-baby, but if you don’t want any scars, and don’t care about the looseness of the deep tissues and skin, a liposuction alone can take care of a stubborn fat pocket.

When my patients ask, “What do I need?” I respond with, “What do you want?” Procedures should be tailored around your goals, expectations, and tolerable downtime.

If your goal is to have your stomach as flat as possible, you probably need some kind of tummy tuck. If all you care about is getting rid of the extra, saggy skin and fat, a skin-only tummy tuck is much less invasive and has a much shorter recovery. If all you want is some improvement and no scars, even if you have stretched-out skin and muscles, liposuction might still be the answer for you.

Located in Beverly Hills, Dr. Suzanne Trott is a board-certified plastic surgeon who specializes in breast and body contouring. Her areas of expertise include liposuction and the new “natural breast augmentation” procedure with autologous body fat. She answers your questions on her blog, Lipo Queen, an international resource for unbiased information regarding all of the newest developments in plastic surgery and cosmetic medicine. Her book, Lipo Queen, will be available next year. Further information about Dr. Trott and her practice can be found at drtrott.com.

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