More than half of women who get tummy tucks are between the ages of 35 and 50, according to the American Society for Aesthetic Plastic Surgery. Many are moms, whose abdominal muscles separated following pregnancy. When that happens, no amount of exercise can bring back the muscle tone.
Thirty-seven-year-old Nicole Powell is slim and muscular, but the birth of her two sons, Brandon and Nathan, took a toll on her body.
"When I'm sitting I still never really sit straight. I've always got that little hunch," says Powell.
"Do you feel like your stomach is not there to support you?," says Carolyn Johnson.
"It's not," says Powell.
"I hear that a lot, but what's really interesting is they don't realize that is a result of the laxity in the abdomen after pregnancies," says Dr. Carolyn Chang, a plastic surgeon at California Pacific Medical Center in San Francisco.
Dr. Chang estimates 95 percent of her tummy tuck patients are moms.
When the belly expands during pregnancy, the tissue that connects the two large abdominal muscles can stretch to the point where it won't snap back. The result is a permanent laxity or overstretching of the abdominal wall.
"So if they have a particularly large birth, if they're older in life, so the tissues aren't as elastic, then it's going to be more lax. If they have multiples or repeated births that can happen," says Dr. Chang.
"From here up, it's fine. From here down, there's just nothing here, no support at all," says Powell.
"No exercise is going to bring that back. That is about stretched-out tissue. It's not about muscle strength or muscle weakness," says Dr. Chang.
Nicole is tired of relying on back braces to get through the day. To her the surgery is a medical necessity, although it is not covered by insurance.
The cost is about $10,000 dollars. She believes it will be money well spent to reclaim her posture and a sense of stability.
A picture taken before surgery shows the sway of her back. Just one week after surgery, her back is already much straighter. The excess skin of her belly is gone as well.
The procedure does leave a noticeable scar, but it sits below the bikini line.
Lucresha Renteria had her tummy tucked two months ago.
"I had heard kind of the nightmare stories of how hard an abdominoplasty is to recover from, that it's the worst plastic surgery you can come through. I was anticipating being in a lot more pain. It wasn't that bad," says Renteria.
"If you over-tighten somebody, then they're going to have a lot of pain. What you want to do instead is you just want to tighten what they need and not overdo it," says Dr. Chang.
Tighten enough to take away the unwanted tummy and give back the abdominal strength that's been lacking.
This is not a problem every pregnant woman suffers from, but Dr. Chang says if you feel unstable, unable to maintain your posture and suffer from back pain since giving birth, you might want to talk over your options with your doctor. Recovery time averages two to three weeks.
Carolyn Chang, MD, FACS
2100 Webster Suite 508
San Francsico, CA 94115