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

Karen M. Horton, MD

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.