Pregnancy represents a completely unique period in the life of a woman. The emotional involvement for future motherhood often coexists with the fear of changes that the body experiences on a daily basis. The pregnant woman is aware that her body will undergo changes during the nine months, some of which are completely irreversible and others destined to leave a permanent mark.
During the pregnancy period, there is an inevitable and progressive increase in weight linked to the increase in uterine mass, water retention and often also to a real increase in body weight. Breast volume increases and enlargement of the pelvis bones occurs, the nipple-areolar complex becomes darker, hair appears thicker and shinier and the increase in cutaneous vascularisation produces more rosy and hydrated skin. It is known that pregnant women are often recognised as “more beautiful”.
At the end of pregnancy and lactation, the areola remains darker, sometimes with a few extra pounds remaining, the breast is more emptied and is less toned but the area that shows the outcomes of pregnancy more than others is the abdominal wall where the skin appears less toned and in some cases, there is a diastasis of the rectus abdominis muscles and stretch marks.
During pregnancy, the uterine volume that hosts the foetus produces a distension of the abdominal wall that generates an inevitable dilation of the aponeurosis that binds the two rectus muscles. The term diastasis indicates the more or less marked distancing along the median line of the rectus abdominis muscles and this phenomenon results in a weakening of the abdominal wall. In most cases, it is a transitory phenomenon that resolves spontaneously a few months after delivery. However, in some circumstances, a permanent diastasis of some extent remains.
The patient feels that the abdomen is not as flat as it was before and when doing abdominal exercises, there is more or less evident swelling when contracting the abdominal muscles which occurs mainly at the navel. The diagnosis is clinical and occurs with a medical examination possibly supported by an ultrasound scan of the abdominal wall or with a computed tomography.
In mild forms it is a modest aesthetic discomfort that can become a functional problem in its most significant forms as it represents a condition of weakness of the abdominal wall that predisposes to the development of hernias.
In most women, the emotional burden of this event is such that it diminishes every other aspect, but in some cases these changes cause problems of non-acceptance of their own body and more and more often plastic surgery becomes a stage that is already planned in the path of recovery of the shape in post pregnancy. The best suggestion that can be given to a woman is to preventatively limit damage as much as possible with proper weight control and adequate skin hydration.
An empty breast is compensated with mammoplasty but it would be worthwhile postponing the operation if another pregnancy is scheduled so as not to frustrate the outcome of the procedure. In the milder cases a correction is possible using lipofilling which allows a volume to be recovered with an autologous fat implant.
An abdomen that is particularly marked with a significant excess of skin or with numerous stretch marks or with a diastasis of the rectus muscles can be improved through abdominoplasty, but in this case the indication of waiting for the end of the reproductive cycle is even more worthwhile. Different from this is the most common case represented by a modest amount of excess skin next to the caesarean section scar. This can be successfully corrected with a mini abdominoplasty. In the most modest cases, it is possible to partially recover the skin tone and turgor by undergoing radio frequency sessions. Mild diastasis cases are correctable surgically with abdominoplasty and direct muscle suturing. In the most severe cases, it becomes advisable to lodge containing netting below the muscular wall on which to lodge the muscles.