Children are the great paradox. All at once, they represent, for their parents, both the Fountain of Youth and the Picture of Dorian Gray.
No question about it, having children keeps us young at heart and young in spirit. As parents, we get to watch, unabashedly and unapologetically, endless cartoons on Saturday morning. We wash gooey peanut butter and jelly sandwiches down with big glasses of chocolate milk. Hide and seek is our competitive sport of choice, and social hour consists either of tea parties with teddy bears or dancing around the family room until we fall down, laughing and dizzy. When our children are born, our eyes are reborn; we see things so clearly, like new, for the first time through the eyes of our children, even though the same things—butterflies, squirrels, dust particles in the sunlight—have passed by our eyes many, many times.
There is one area, though, in which children do not provide eternal youth for the mothers who carry and give birth to them: our bodies. The wonderful end result of pregnancy is your beautiful child; the unwanted and often unexpected side effects can include stretched out skin around the belly, and breasts that are bigger, smaller, or just not the same as they were before pregnancy and nursing.
Many women are comfortable or accepting of the physical changes that come with childbirth and nursing. Yet some women find the changes in physique so drastic, they are looking for bodies to match their youthful attitudes. While plastic surgery is not for everyone, it can be an answer for some.
The Hot Spots
The two most popular areas of the body for post-pregnancy plastic surgery are the breasts and the belly. Dr. Elliot W. Jacobs, FACS, a plastic surgeon in New York City, points out what every woman who has been pregnant knows: "The breasts and abdomen both change drastically during pregnancy."
Breasts enlarge during pregnancy and lactation, which stretches the skin around them—and if you aren't blessed with very elastic skin, that skin doesn't shrink back to its original size. If the breasts also lose volume after pregnancy (called postpartum atrophy), then a larger amount of skin is holding a smaller volume of tissue, resulting in sagging breasts. The effect is like wearing a bra that is one size too big. The solution: a breast lift, or mastoplexy, a surgical procedure that raises and reshapes sagging breasts. Breast augmentation and reduction are also common surgeries after pregnancy, and are often combined with a breast lift.
The most popular post-partum cosmetic surgery procedure is abdominoplasty, or the tummy tuck, and it's growing in popularity. In 2001 there were 71,123 abdominoplasty procedures, according to the American Society for Aesthetic Plastic Surgery, compared to 58,426 in 2000, and only 34,002 in 1997.
No Need To Rush
You should not make the decision to have plastic surgery quickly or without great thought—and your doctor should make sure you have all the information you need to make that decision. "There is a certain amount of pain and discomfort," says Dr. Jacobs. "And there are risks, though they are small."
Make sure that your surgeon answers all your questions regarding price, surgery, recovery, and the end result. According to the American Society of Plastic Surgeons, average physician fees (not including operating room and anesthesiology fees) for the procedures are:
- Tummy Tuck: $4,205
- Breast Augmentation: $3,043
- Breast Lift: $3,503
These costs, which will vary greatly across the country, are your costs—cosmetic surgery is not covered by insurance. Breast reduction, however, is often considered "medically necessary" and may be covered, because very large breasts can cause health problems, such as severe back pain. Surgeons' fees for breast reduction average about $4,000. Insurance coverage varies, but the fee that Medicare will reimburse for breast reduction surgery is about $1,700.
Your doctor should discuss with you whether or not you are a good candidate for surgery. Women who may not be good candidates for post-pregnancy plastic surgery include those who are very overweight, smokers (because smoking interferes with post-surgery healing), and those who already have scars on their abdomen, which could limit the tightening that can be done as well as limiting the blood supply.
Most doctors urge patients to wait to have plastic surgery until they are done having children. "Anything we do should be considered after a woman has had all of her children," urges Dr. Jacobs. "Everything we do could be undone by another pregnancy." In addition, any breast surgery could affect your ability to nurse your children.
Lou Ann Moritz waited plenty of time after her third and fourth children, twins, were born in 1966. She had a tummy tuck in 1988 and continues to be very happy with the result. "I couldn't get rid of my stomach, mainly loose skin, with exercise or diet," she says. Now, 14 years after the surgery, she has been able to keep excess weight off, and her stomach is still flat. "I feel that there is a connection between keeping my weight down after having the surgery," says Moritz. "[The surgery] was painful and costly and it would all be lost if I gained weight."
Even with the most skilled surgeon, you must set realistic expectations. "I like to use the word 'improve.' I can't 'remove.'" says Dr. Darrick Antell, FACS, also a plastic surgeon in New York City, as well as a spokesperson for the American Society of Plastic Surgeons. He says that when his patients have realistic expectations, and don't expect absolute perfection, they drastically increase their satisfaction. The same theory holds true with your children, the ultimate reality.