Feeling sexy is one thing while being sexy is another thing. What makes a woman truly irresistible and desirable is how she presents her physical assets. All this talk about physical assets becomes nightmarish when a woman gets pregnant. A lot of changes occur in a woman’s body during pregnancy. The likes of expansion and enlargement of the abdominal anatomical structure, leading to skin stretching that results in stretch marks, sagging skin, accumulation of abdominal fats (women eat a lot during pregnancy), and skin discoloration. The breast, too, becomes full, resulting in overstretching the skin together with skin color changes.
Stretch marks (stria distensae) are one of the most-talked-about skin changes that can occur during pregnancy. Almost 90% of pregnant women will experience stretch marks. Stretch marks appear as pinkish or reddish streaks running down the abdomen and/or breasts, and are very repulsive to look at. They are the result of the skin being subjected to continuous and progressive stretching. Increased stress is placed on the connective tissue due to the increased size of the various parts of the body. Stretch marks occur not only on the abdomen but on the breasts of pregnant women, too, as well as on the shoulders of body builders, in adolescents undergoing growth spurt, and in individuals who are overweight. Add to these, those on prolonged use of oral or topical corticosteroids or those with Cushing’s syndrome (increased adrenocortical hormone activity by adrenal glands).
Stretch marks are a reflection of “breaks†in the connective tissue of the skin. Skin distension may lead to excessive mast cell degranulation with subsequent damage of collagen and elastin. But it is not only striae that makes a woman’s abdomen unsightly but also the presence of a severely crinkled, excess skin that overhangs in front of the waistline like a crumpled apron. Heat and maceration occur underneath this overhanging skin, leading to intertrigo (an inflammatory rash of the body folds or adjacent areas of skin) where recurrent fungal, bacterial, and even viral infection can occur. What is revolting is that sometimes, the area would emit a foul odor as exposure to air is precluded in these areas. This abdominal deformity is a result of excess skin and subcutaneous tissue plus laxity of the abdominal wall musculature. The most significant area of the defect is around and below the umbilicus, where excess skin over a diastasis (separation between the left and right side of the rectus abdominis muscle, which covers the front surface of the belly area) of the rectus muscles is most apparent. These changes in a woman’s physical attributes need a lot of overhauling especially after multiple pregnancies, to restore the body’s original skin texture, color and contour. In current practice, even with the significant dermatologic advances in topical medicaments and light-based devices, total resolution of these lesions remains an unattainable goal.
Striae distensae most likely respond to pharmacologic products and clinical interventions at their early stage (striae rubra). Once they become white (striae alba), only few treatment modalities exist and they become quite difficult to improve. Intensive moisturization, use of vitamin C, fruit acids, retinols and other pharmaceuticals have been advocated for the early treatment of striae distensae rubra. Some of these, however, should not be used by breastfeeding mothers owing to a theoretical concern about its teratogenic (aborting a fetus) effects. As for the other discoloration problem, a whitening cream can hasten its resolution. However, these drugs are to be totally avoided by nursing mothers.
Patients with excessive or saggy abdominal skin, with or without excess fat, with plenty of deep, wide striae distensae are best suited to undergo a tummy tuck or abdominoplasty procedure.
Although the operation can be performed on people who still have some weight to lose, the best results are always seen in people who are already at their best sustainable weight. Women who are no longer thinking of another pregnancy are candidates for this procedure. It is also indicated for those who have attempted weight loss through exercise but failed. And it’s definitely for men and women who have excess skin and fat in the “love handles†and hypogastric areas (below the umbilicus).
The procedure involves removal of excess fat (through liposuction) in front, above, and below the umbilicus, removal of the apron-like, crinkled skin, repositioning of the umbilicus, tucking the rectus abdominis muscle to correct the diastasis. Unlike the medical treatment for striae distensae which does not guarantee its removal, abdominoplasty will totally get rid of stretch marks, except those that are above the umbilicus. The goal is to help regain one’s pre-pregnancy belly and eliminate stretch marks, correct the weakening of the abdominal wall, remove excess skin resulting from significant weight loss, and help reverse accumulation of fat in the midsection due to aging.
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