A high percentage of tummy tucks performed are after a woman is done having children. They often aren’t happy with the stretched out look that bearing children has created on their abdomen. There may be loose skin, stretch marks, and decreased muscle and fascial tone, causing the abdomen to bow outwards.
But what about those women who have not yet had children, but feel they could benefit aesthetically from having a tummy tuck? I often see patients who have experienced significant weight loss and have the same concerns that moms may have, with stretched out skin.
This definitely comes up in my practice from time to time. It is really not a problem. They can have a tummy tuck without issue, but if I know that they will likely have children, I just avoid tightening their fascia, the the thin layer that overlies the abdominal muscle and helps to keep it flat. This allows me to excise the extra skin and fat and give them a tighter look. When and if they get pregnant, the skin and muscle will stretch. How it will look after their pregnancy is impossible to predict, but oftentimes it will be much better than if they did not have the tummy tuck, especially if they are careful to eat in a healthy, controlled fashion and maintain their workouts. I can, of course, still do liposuction to their flanks (love-handles) to help give them a more contoured look. Of course, if they know they are going to have a child soon (in the next 2 years or so), then it makes more sense to wait until after the pregnancy.
What happens to those women who think they will have no more children and have a TT and then find themselves pregnant? Ultimately, the child always wins. The abdominal wall will stretch and the internal sutures will stretch or break. This has obviously happened to women on numerous occasions. However, if i know of these plans in advance, I would simply not tighten the fascia for this reason.