WOMEN'S PLASTIC SURGERY: September 2009

Monday, September 7, 2009

Stretch marks - Unlikely to be caused by surgery, but expected after pregnancy

Karen M. Horton, MD answers:

Will Breast Implants and Liposculpture cause stretch marks after pregnancy?

I am 32 and I am planning to have a breast augmentation (something discreet) and a liposculpture within the next two weeks, but also I would like to get pregnant of my second baby in about 10 months. I did not get any stretch marks at all from my first pregnancy, but I am really concerned that the breast implants or the Lipo will cause them when I get pregnant again. Any opinions?

Brenda, Chicago

By Karen M. Horton, MD - San Francisco Plastic Surgeon

Stretch marks ("striae") are a common occurrence after rapid weight gain or stretching of the skin, as in puberty or pregnancy.

Striae are caused by a small tear in the dermis (lower layer of the skin) th

at heals by filling itself in with scar tissue. The epidermis (top layer of the skin) remains intact, but is often stretched out, enabling the scar tissue below to be visible as a shiny, irregular and sometimes depressed area of skin.

One study estimated that between 75% and 90% of women develop some degree of stretch marks after pregnancy, usually in the lower belly region.

Unfortunately, stretch marks are permanent. Although they tend to fade with time, like all scars, they are permanent, like scars.

Despite many claims, topical creams and other therapies to the skin cannot eliminate or remove stretch marks. The only way to permanently remove stretch marks is to surgically excise them, for instance, in a tummy tuck. Many moms are proud of their stretch marks, as they remind them of their pregnancies and their beloved little ones!

A breast augmentation and liposuction would be very unlikely to create stretch marks, so long as the breast implants were not so large that they caused massive stretching and tearing of the dermis of the breast skin. By a "discrete" breast augmentation, I assume you are aiming for a natural, subtle result. This would be highly unlikely to create any striae.

You are lucky that you did not have stretch marks following your first pregnancy. This may be because of your age and genetics. Hopefully, you will continue to enjoy a body free of stretch marks. However, changes occur with each and every pregnancy, and you may discover some new striae after your next pregnancy.

Best of luck, and congratulations on your family!

Karen M. Horton, M.D., M.Sc., F.R.C.S.C.

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Stretch marks ("striae") are a common occurrence after rapid weight gain or stretching of the skin, as in puberty or pregnancy. Striae are caused by a small tear in the dermis (lower layer of the skin) that heals by filling itself in with scar tissue. The epidermis (top layer of the skin) remains intact, but is often stretched out, enabling the scar tissue below to be visible as a shiny, irregular and sometimes depressed area of skin. One study estimated that between 75% and 90% of women develop some degree of stretch marks after pregnancy, usually in the lower belly region. Unfortunately, stretch marks are permanent. Although they tend to fade with time, like all scars, they are permanent, like scars. Despite many claims, topical creams and other therapies to the skin cannot eliminate or remove stretch marks. The only way to permanently remove stretch marks is to surgically excise them, for instance, in a tummy tuck. Many moms are proud of their stretch marks, as they remind them of their pregnancies and their beloved little ones!A breast augmentation and liposuction would be very unlikely to create stretch marks, so long as the breast implants were not so large that they caused massive stretching and tearing of the dermis of the breast skin. By a "discrete" breast augmentation, I assume you are aiming for a natural, subtle result. This would be highly unlikely to create any striae.You are lucky that you did not have stretch marks following your first pregnancy. This may be because of your age and genetics. Hopefully, you will continue to enjoy a body free of stretch marks. However, changes occur with each and every pregnancy, and you may discover some new striae after your next pregnancy. Best of luck, and congratulations on your family!Karen M. Horton, M.D., M.Sc., F.R.C.S.C.

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Designing scars for tummy tucks - You have input!

Karen M. Horton, MD answers: Different location and direction of Tummy Tuck incisions?

Why are some Tummy Tuck incisions straight across and some in a dramatic "u"? Is there an advantage to the "u"?

Aromagal Vancouver BC

By Karen M. Horton, MD - San Francisco Plastic Surgeon

A tummy tuck ("abdominoplasty") requires creation of a longish scar across the lower abdomen, and usually also around the belly button.

During a tummy tuck, excess skin and fat is removed from the lower belly, and the muscles of the abdominal wall are brought together by a technique called "rectus fascial plication".

Adbominoplasty is really a three-dimensional operation, serving to corset your midline from the inside, and tuck excess skin and fat on the outside! It is an incredible procedure for some women who are good candidates.

The location of the incision can be designed to fit within your normal swimsuit or undergarment lines.

Some women wear very low-cut bathing suits or jeans, and wish their scar to be as low and horizontal as possible.

However, other women may wear a more high-cut undergarment or bikini bottom, and may wish the scar to lie slightly higher. Most women know which cut or style of bottom flatters their figure most, and tend to stick to that style.

You can bring your undergarment with you to a consultation with a Board-Certified Plastic Surgeon and show your Plastic Surgeon where the ideal location for the scar to lie, if possible.

Remember, however, that styles and fashions can change. Scars are permanent, but fade dramatically with time.

If you are seriously considering a tummy tuck, stay involved with the planning process and don't be shy about asking your Plastic Surgeon to tailor the procedure so that it suits your body, fashions and lifestyle the very best!

Karen M. Horton, M.D., M.Sc., F.R.C.S.C.

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A tummy tuck ("abdominoplasty") requires creation of a longish scar across the lower abdomen, and usually also around the belly button.During a tummy tuck, excess skin and fat is removed from the lower belly, and the muscles of the abdominal wall are brought together by a technique called "rectus fascial plication". Adbominoplasty is really a three-dimensional operation, serving to corset your midline from the inside, and tuck excess skin and fat on the outside! It is an incredible procedure for some women who are good candidates. The location of the incision can be designed to fit within your normal swimsuit or undergarment lines. Some women wear very low-cut bathing suits or jeans, and wish their scar to be as low and horizontal as possible.However, other women may wear a more high-cut undergarment or bikini bottom, and may wish the scar to lie slightly higher. Most women know which cut or style of bottom flatters their figure most, and tend to stick to that style.You can bring your undergarment with you to a consultation with a Board-Certified Plastic Surgeon and show your Plastic Surgeon where the ideal location for the scar to lie, if possible.Remember, however, that styles and fashions can change. Scars are permanent, but fade dramatically with time. If you are seriously considering a tummy tuck, stay involved with the planning process and don't be shy about asking your Plastic Surgeon to tailor the procedure so that it suits your body, fashions and lifestyle the very best!Karen M. Horton, M.D., M.Sc., F.R.C.S.C.

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