Friday, August 12, 2011

Tummy Tuck with Labor



I am occasionally asked to perform a tummy tuck at the same time as a lady gives birth. I certainly understand the desire to combine these two procedures. The lure is that “as long as we are there….”.

There are several very serious pitfalls that make this a very unwise decision in my opinion.

The first is the patient’s safety. Mothers at the time of delivery often have issues with blood clotting. They can either clot too easily or clot too much. There are various reasons for this but the reality is that mothers have an exaggerated tendency to bleed or clot. For safety sake combining this with a procedure that has a small but real risk of deep vein thrombosis or blood clots seems particularly unwise. The last thing I want to do is hurt a brand new mother. Pregnant women also have an altered immune system. This in theory could make them more prone to having wound healing problems or infections. A mother with a new born baby may want to breastfeed and would not want to be on antibiotics should that be needed.

The second reason is that you would get a suboptimal result. There are a couple reasons for this. One is that ladies tend to retain water so their tissue is quite edematous at the time of delivery. This is going to restrict how much skin you can get off and limit the success of the operation. Also, mothers should be given a chance to lose some of their baby weight. This will enhance their result that the surgeon can achieve for her.

Next is that the uterus is also swollen and taking up more space than it will after the lady has recovered from pregnancy. This is going to limit on how tight you can get the abdomen.

Overall I think doing a tummy tuck at the same time as delivering a baby is ill-advised. It compromises the safety of the mother while giving her a suboptimal result. 

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