Plastic surgery along with cesarean section? Can you?

"Dr., I'm going to have a caesarean section and I wanted to have a plastic surgery and already fix 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 body before pregnancy as early as possible, along with the convenience of ? enjoy the same surgery? make this question an almost logical question. To answer it, we need to look at some facts:

First, the best thing to do during a pregnancy is to put on the minimum necessary weight gain. In pregnancy, the skin is stretched at a very high speed. In nine months she suffers a life-long stretch she never suffered. This leads to 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 and is less damaged. A healthy weight for mother and child to gain during pregnancy is 10 kg. This means that between the child's weight, placenta, amniotic fluid, swelling, the total amount is almost 8 kg, leaving about 2 fat left over.

Thus, after delivery, it is easy to return to pre-pregnancy weight, since in practice the mother gained only 2 kg. Properly moisturizing the skin of the abdomen and breasts makes the skin less susceptible to rupture of the elastic fibers, and therefore to stretch marks. All weight gain beyond 8 kg (in a normal pregnancy) is pure fat, which does not help the child's development and only harms the mother. A large overweight can raise the mother's blood pressure, increase blood glucose and even lead to eclampsia, a very serious complication.

Unfortunately, few have the difficult determination to control weight and reach the end of 9 months with less than 10 kg gained. Most arrive with 15 kg, 50% more than they would need. To lose these undesirable surpluses the fight is much bigger, getting harder with each passing month. It is as if the body got used to the new shape and took overweight as normal weight. It is therefore important to return to pre-gestational 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 is higher in the association 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 is called embolism, a potentially fatal complication.

Another important factor is the recovery of a tummy tuck requires care, such as not carrying weight, making no effort, being slightly bent, which would make breastfeeding quite difficult and uncomfortable. The musculature of the abdomen after childbirth is also fragile and more flaccid due to distension, making it difficult to evaluate the degree of plication ("stitching") of the muscle to be performed.

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

Therefore, I see no plausible reasons for to associate abdominoplasty and / or liposuction with cesarean section, because the risks would be higher and the result worse than if the abdominal plastic surgery were performed at different times, with the patient at the ideal weight.

I believe it is wiser to expect to return to the pre-pregnancy weight, recover from childbirth, stop breastfeeding and thus operate more safely, comfortably and with the best possible outcome. It is worth remembering that the cost of the associated surgery would not be much different from the separate surgeries, since the plastic is not covered by the agreement, nor the hospital part.

Caesarean section evidence-based surgical technique (April 2024)