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Postpartum Rejuvenation

 

Besides adjusting to motherhood, many new mothers have concerns about the postpartum recovery. Not only losing the extra weight gained during pregnancy, but also getting the post-pregnancy body back in shape. During pregnancy, the pelvic muscles become stretched and lose elasticity, pressing the vagina into funnel- or kettle gourd-like shape (as shown in the Figure).

 

 

 

After childbirth, women may feel the vagina lose tautness, and many believe Caesarian section delivery can avoid vaginal laxity. However it is not true. Whether vaginal delivery or Caesarian section delivery, it is impossible to completely avoid vaginal laxity. Thus we suggest the mothers-to-be follow the obstetrician/gynecologist's advice to choose the most appropriate way of delivery depends on individual's condition and no need to consider much about vaginal laxity issue. Ultimately the most important is to safely give birth to a healthy baby.

For women with mild vaginal laxity after childbirth, Kegel exercises are quite effective to restore vaginal tightness. For those with severe symptoms, we recommend the patients undergo vaginoplasty to improve sexual satisfaction.

 

To do Kegel exercise is like pretending you have to hold the urine. When you first start Kegel exercise, you can try to stop urine in midstream and feel those muscles (i.e. pelvic floor muscles) you use to hold in urine. One Kegel exercise is to follow the steps of squeezing the muscles, holding for 4-5 seconds, and then relax. You can start with practicing one Kegel exercise four times a day. When you get more familiar, you can further practice it when you are standing by squeezing your buttocks together, squeezing the muscles and feeling the pelvic floor move up, keeping tightening the muscles in your anus and urethra, holding for 5 seconds, and relax for 5 seconds. If you repeat doing 20 Kegel exercises on a daily basis, you can expect to see improvement.

 

Vaginal Rejuvenation/Vaginoplasty

Traditional vaginoplasy removes part of mucosal tissues, tightens the submucosal connective tissues with sutures, followed by closing the mucosa, which can be performed under local anesthesia with no surgery-related complications. However traditional vaginoplasy does not involve in suturing the perineal muscles so the vaginal tightening effect is limited. In Charm United Institute, we perform vaginoplasty that involves suturing the submucosal connective tissues and the perineal muscles, to ensure permanent vaginal tightening effect. The surgery is performed under intravenous general anesthesia, which lasts about an hour. Mild bleeding may happen after the surgery, which can be alleviated with warm water sitz bath and application of topical antibiotics to the wound.


Vaginoplasty Precautions:
1.
Vaginoplasty is recommended for women who are not considering having more children. Otherwise vaginoplasty may cause difficulty in future vaginal delivery and the vagina stretching out again.
2 .
Patients are prohibited from having sexual intercourse within 4 weeks after surgery to avoid tearing of surgical wound.
3.
It is recommended to wait 6 months after childbirth to undergo vaginoplasty. Usually women with an uncomplicated vaginal delivery will recover vaginal tightness within 3-6 months of having the child. If not, it is never too late to consider vaginoplasty.

 

Tummy Tuck/Abdominoplasty

The belly after a full-term pregnancy is like a deflated balloon, sagging and flabby. Exercise can firm the abdominal muscles and burn the belly fat but cannot help tight up the loose skin. Abnominoplasty provides a solution of flattening the mummy tummy.

 

Complete Abdominoplasty

A transverse incision is made above the pubic hair. The skin is detached from the fascia and stretched. Excess skin and fat are removed and the abdominal wall is reinforced. Then the skin is pulled back down, followed by incision closed with sutures. The navel is repositioned to achieve aesthetic improvement.

 

 

Complex abdominoplasty : (Complete abdominoplasty + water-assisted liposuction)

 

Complete abdominoplasty can correct excess sagging skin and Diastasis recti. However for patients who are overweight or with significant amount of excess fat, complex abdominoplasty combining liposuction and abdominoplasty is recommended to achieve the goal of lower body contouring. In Charm United Institute, we strictly adopt the innovative SAFELipo liposuction technique that incorporates three steps

“S” fat separation from surrounding vessels, nerves, muscles and fascia tissues;

“A” fat aspiration;

"FE" fat equalization evens out the fat left in the subcutaneous layer.

In hand of an expert surgeon with great patience and extreme carefulness, SAFELipo can produce smooth, toned and natural contours.
Loose abdominal skin problem is often coupled with belly fat accumulation. Complex abdominoplasty can fix both problems and improve the contours.

 

 


Fat transfer breast augmentation combined with nipple reduction surgery
Pregnancy and childbirth may not only cause vaginal laxity but also changes in breasts. During pregnancy and breastfeeding, the breasts become fuller and heavier. After weaning the child, the breast milk dries up and the breasts may become sagging and the nipples bigger and longer, of which the severity is correlated to the duration of pregnancy and breastfeeding. In this case, fat transfer breast augmentation that collects the fat gained during pregnancy and inject it into the breasts is recommended for breast contouring.

 

 

 

Nipple reduction surgery does not damage the mammary glands and therefore will not affect the breastfeeding function.

Ideal Nipple Size
 In general the ideal measures and proportions of an un-erected nipple in mature women is with a size of 0.8-1 cm in diameter, 0.6-0.8 cm in length and a nipple to areola ratio of 1:3. Too small nipple size will make it more of a man and therefore not aesthetically pleasing in women.

 

 

Nipple Reduction

 Nipple reduction is basically a surgical operation aiming at reducing the length and/or the width of the nipple. Four types of surgical procedures can be applied either individually or combined to achieve the ideal nipple size.

 

 

 

 

Q 1.How soon after childbirth can I have vaginoplasty?

It is recommended women should wait at least 3 months after childbirth to undergo vaginoplasty when the body has been fully healed after delivery. Breastfeeding mothers underwent vaginoplasty should stop breastfeeding for 1 week to avoid the anesthetic drugs getting into your baby.

 

Q 2.Does vaginoplasty affect vaginal lubrication during sexual intercourse?

No, vaginoplasty does not affect vaginal lubrication. In fact vaginoplasty helps in reducing the risk of vaginal infection and abnormal discharge associated with loose vagina.

 

Q 3.What's the difference between vaginoplasty and the suturing of an episiotomy following vaginal childbirth?

The surgical repair of loose vagina performed in most OB/GYN clinics only reduces the opening of the vagina by 3-6 cm. In Charm United Institute, we perform vaginoplasty that tightens the muscle tissues in the full length of the vaginal cannel from the opening of the vagina to the tip of the cervix, which ensures a better vaginal tightening effect.

 

Q 4.Does abdominoplasty cause damage to internal organs?

No. Abdominoplasty only removes excess skin and fat and tighten the muscle and fascia of the abdominal wall, which is performed outside the abdominal cavity and therefore is completely different from a laparotomy.

 

Q 5.Can abdominoplasty remove the stretch marks?

Stretch marks are caused by tearing of elastin fibers in the dermis due to skin overstretch. They appear as long, narrow streaks or lines on the skin. Stretch marks don't disappear naturally after formation. Laser therapy and Dermabrasion are not very effective in removing stretch marks. During abdominoplasty, stretch marks below the belly button can be removed together with the excess skin, and the rest of the stretch marks will become less invisible when the belly skin gets tightened.

 

Q 6.Does nipple lose sensation after nipple reduction surgery?

Nipple reduction surgery involves only skin removal and suturing at the nipple-areola area and does not damage the sensory nerves of the nipple. Temporary numbness at the nipple-areola area may occur after nipple reduction surgery, which usually subsides within one month.

 

Q 7.Does fat transfer cause lumps or persistent swelling and redness? How to solve it?

What you refer to the lumps should be fat fibrosis and the persistent swelling, and redness should be inflammation caused by fat necrosis. If limited area is affected, we suggest conservative treatment with observation. Most lesions will disappear within 1-2 months. However if subcutaneous accumulation of fluid or pus occurs, incision or suction drainage is indicated.

 

 

  1. Do not ride a motorcycle or drive home after surgery (for patients who received eye or sleep anesthesia).
  2. Avoid strenuous exercise and do not lift heavy objects within two days after operation to avoid blood vessel rupture and swelling.    
  3. Do not remove the bandages or fixing device yourself.    
  4. Apply ice compression on the first 2 days (48 hours) after the surgery, and from the third day on, apply warm compression until the swelling is gone (please pay attention to the temperature of warm compression to avoid burns).    
  5. Take medication on time for 4 times a day (after meals and before sleep). If the pain is severe, take painkillers once every 3 hours.    
  6. Wound care: Use saline solution and cotton swabs to clean the wounds, wipe dry, and then apply the ointment every morning and evening.    
  7. Don't let the wound contact with water within 2 days after the surgery. From the third day on, use clean water to clean the wound. Do not use cleaner within 7 days after surgery to avoid irritation.
  8. Do not smoke, drink alcohol, tea or coffee, or have pepper and other irritating food within a week after the surgery to avoid affecting the postoperative wound from healing.    
  9. No seafood during the first week after the surgery to avoid allergies (except for fresh fishes).
  10. Avoid wearing contact lens, facedown position or any movement that may stretch face muscle or increase blood pressure for one week.

 

Dr. Yi-Sheng Kao Director | Plastic Surgery Aesthetic Clinic

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