Plastic surgery together with cesarean? He can?

“Dr., I’m going to have a cesarean and I wanted to take the opportunity to have a plastic surgery and correct the abdomen!”

This is one of the doubts of almost all women who see their body changed after one or more pregnancies. The anxiety and expectation of having the pre-pregnancy body as soon as possible, together with the comfort of “enjoy the same surgery” make this question an almost logical question. To answer it, we need to analyze some facts:

First, the best thing to do during pregnancy is to gain as little weight as necessary. In pregnancy, the skin is stretched at a very high speed. In nine months, she suffers a strain that she has never suffered in her entire life. This leads to the rupture of the elastic fibers, which results in the dreaded stretch marks.

Therefore, the best thing to do is to minimize this stretch as much as possible, so that the skin suffers less, is less injured. A healthy weight for mother and child to gain during pregnancy is 10 kg. That is to say, between the weight of the child, placenta, amniotic fluid, swelling, almost 8 kg are totaled, leaving about 2 kg of excess fat.

Thus, after childbirth, it is easy to return to the pre-pregnancy weight, since in practice, the mother gained only 2 kg. Moisturizing the skin of the abdomen and breasts well makes the skin less susceptible to the rupture of elastic fibers, and therefore, to stretch marks. All weight gain beyond 8 kg (in a normal pregnancy) is pure fat, which does nothing to help the child’s development and only harms the mother. A great overweight can raise the mother’s blood pressure, increase blood glucose and even lead to eclampsia, a very serious complication.

Unfortunately, there are few who have the difficult determination to control their weight and reach the end of 9 months with less than 10 kg gained. Most arrive with 15 kg, that is, 50% more than they would need. To lose these undesirable surpluses the struggle is much bigger, getting more difficult with each passing month. It’s as if the body gets used to the new shape and takes the overweight as normal weight. That’s why it’s important to return to pre-pregnancy weight as soon as possible, ideally within two months.

Regarding the association of abdominal and gynecological plastic surgery (this includes cesarean section, hysterectomy, others), we need to consider some factors. It is known that the risk of thrombosis and infection are higher in the combination of these surgeries.

Thrombosis is the formation of a clot, usually in the veins of the legs, that forms during or after surgery, due to lack of circulation. If this clot ends up in the lung, it’s called an embolism, a potentially fatal complication.

Another important factor is that recovery from a tummy tuck requires care, such as not carrying weight, not making efforts, being slightly bent over, which would make breastfeeding quite difficult and uncomfortable. The musculature of the abdomen after childbirth is also weakened and more flaccid due to distension, making it difficult to assess the degree of plication (“sewing”) of the muscle to be performed.

As tummy tuck It is a surgery to remove the skin and flaccidity of the abdomen, it has better results in patients with ideal weight and without excess fat or swelling. Remembering that the vast majority of patients do not arrive at birth with ideal weight, but in excess. Therefore, it is concluded that these patients would not have the best possible result, if they decide to have plastic surgery at the time of delivery.

Therefore, I see no plausible reason in associate abdominoplasty and/or liposuction with cesarean sectionbecause the risks would be greater and the result worse than if the abdominal plastic surgery were performed at different times, with the patient at an ideal weight.

I believe it makes more sense to wait to return to the pre-pregnancy weight, recover from childbirth, stop breastfeeding and thus operate with more safety, comfort and with the best possible result. It is worth remembering that the cost of associated surgery would not be very different from separate surgeries, since plastic surgery is not covered by the agreement, nor by the hospital part.