Overstretched skin, a bulging belly and sagging breast. You knew you would have some type of change in your body after pregnancy, but you thought that was only temporary. For those mothers trying to get back into shape, there's good news and bad news. The bad news is no amount of exercise, doctors say, can reverse these common postpartum after effects of giving birth. The good news is plastic surgery can be a viable solution to banish that bulging belly and boost those flabby breasts.

No doubt you are wondering why you can't just pop in your new Pilates DVD or pump up on your Bowflex machine. "Exercise can't do it, since there is no muscle in the midline for you to exercise," writes James M. Nachbar, MD, FACS, in his web site report.
What Dr. Nachbar is referring to are the rectus muscles (six-pack muscles). These are the muscles that get stretched as the baby grows inside the uterus. In some pregnancies, this muscle actually gets pulled apart as the baby grows. "Once that has happened," writes Dr. Nachbar. "Nothing other than surgery can bring them back together."
In addition to the muscle, skin gets stretched as the baby grows, explains Dr. Nachbar. Once the baby has been delivered, the skin collapses, leaving it loose and hanging. Experts agree that while exercise can tighten un-torn muscle, it can not tighten skin that has been stretched beyond its limits.

Fortunately, surgeons have ways to treat this problem. The most common way is via a lipectomy or abdominoplasty. With a lipectomy, a surgeon can remove the excess skin from the belly by cutting it off, thus reducing or eliminating the stretch marks and even a C-section scar. According to Patrick Hudson, MD, FACS, many women who are done having children, have this operation done at the same time as a tubal ligation (tying the fallopian tubes) or hysterectomy (removing the uterus).
However, when the muscle is torn or needs to be tightened, the patient can get an abdominoplasty or mini-abdominoplasty. An abdominoplasty tightens the entire rectus muscle. A mini-abdominoplasty tightens the muscle and skin of the lower abdomen beneath the belly button.

If a patient has too much fat in this area, the surgeon might recommend liposuction first, where fat is surgical suctioned out of the body through tiny openings. Liposuction is also good for treating other stubborn postpartum problem areas like the thighs, upper arms and buttocks. For more information on the various liposuction techniques available, read Liposuction Techniques: Melt, Cut or Dissolve?

Kimberly Hill, of Macomb Township, Mich, had liposuction and a tummy tuck after the birth of her two children. "I never have wanted to look like a supermodel," says Hill in a recent interview with Cosmetic Magazine. "I just wanted to have back what I once had."
Another big problem for women after they have given birth is sagging breast. However, clarifies Dr. Hudson, these changes actually occur during the pregnancy when the glands in the breast become engorged with milk. When this happens the milk replaces the fatty tissue in the breast. Once a woman gives birth and stops breast feeding, the glands become inactive and shrink. Unfortunately, the fat that was once there does not return to "re-fill" the breast. "What's left is a skin "envelope" with little to fill it," notes Dr. Hudson on his web site. "This causes the breasts to look less full or sag."

To correct this problem, the surgeon can do a mastopexy (lift the breast) or insert breast implants. However, some patients need both procedures to get the maximum results. During a mastopexy, the surgeon removes excess skin, and then tightens the skin. With implants, the surgeon can insert the implant under the muscle (the pecs) or above it.

However, implants tend to hold up better when placed under the muscle.
While these are the most common postpartum problems for women, there are two other areas of concern. Vaginal tearing to the labia (the opening to the vagina) is a problem experienced by many who have a vaginal birth. A woman can have this repaired with labiaplasty, writes Dr. Hudson.

Still, other women develop what's called the "pregnancy mask" (aka chloasma). "Some studies suggest that three in four women may develop these changes, which are characterized by a blotchy brown increase in pigment," notes Dr. Hudson. He advises using a skin bleaching cream to diminish the appearance of this discoloration.
If you're a mom thinking about a postpartum procedure, then you should consider the costs. Liposuction can cost up to $13,500, breast augmentation $8,000, lipectomy/ abdominoplasty $6,000-$8,000, and labiaplasty $3,500. Patients should also keep in mind that results and healing are not overnight. Recovery can take anywhere from several weeks to several months, depending not only on the number of procedures you have done at the same time, but also your pre-existing health.