What Pregnancy Changes, and What Surgery Can Address

Some of what pregnancy changes reverses on its own. Some of it does not — separation of the abdominal muscles and loss of skin elasticity do not respond to diet or exercise, because neither is a matter of fat.

Hormonal change

Hormones drive most of the physical changes of pregnancy. Increases in oestrogen and progesterone affect several body systems:

• Increased blood flow and hormonal influence lead to breast enlargement, tenderness or increased sensitivity.
• The uterus grows substantially through gestation.
• Blood volume, heart rate and blood pressure all change.

The first trimester

• Early signs. Missed periods, breast tenderness and nausea signal the change.
• Breast and uterine change. Swollen or tender breasts from increased blood flow and hormonal adjustment; the uterus begins to expand.

The second trimester

• Abdominal expansion and weight gain. The abdomen expands progressively alongside the weight gain needed to support the pregnancy.
• Skin and hair. Many women notice changes in the skin, such as increased oiliness, along with changes in hair growth from hormonal shifts.
• Musculoskeletal change. Hormones released during gestation relax ligaments and joints in preparation for childbirth, which can cause discomfort, particularly in the lower back and pelvis.

The third trimester

• Respiratory change. The expanding uterus presses on the diaphragm, making deep breathing more difficult and causing breathlessness on exertion. Deep breathing exercises and good posture help.
• Digestive change. Hormonal variation slows digestion, producing heartburn, constipation or bloating. Smaller, more frequent meals help.
• Preparing for birth. Braxton Hicks contractions become more noticeable. The cervix softens and thins in anticipation of dilation.
• Pelvic pressure. The weight of the growing fetus produces increased pelvic pressure and discomfort around the pubic bone or lower back.
• Urinary frequency. As the baby descends into the pelvis, pressure on the bladder increases urinary frequency.
• Swelling. Swollen feet and ankles from fluid retention and reduced circulation. Elevating the legs, wearing comfortable shoes and avoiding prolonged standing help.

Regular antenatal care throughout the third trimester allows any complication to be identified promptly.

After delivery

Uterine involution

The uterus contracts back towards its pre-pregnancy size over several weeks. This can cause mild cramping, known as afterpains.

Hormonal change

Hormone levels fluctuate significantly after delivery as they return towards their pre-pregnancy state. These shifts can produce mood changes, fatigue and temporary hair loss.

Breast change

The breasts change through pregnancy and breastfeeding. They may become swollen and tender initially from increased blood flow and milk production. On weaning they may feel engorged or leak temporarily before returning towards their previous size.

Emotional wellbeing

Emotional recovery matters alongside physical recovery. Many new mothers experience a range of emotions. Emotional distress beyond the immediate post-natal period should be discussed with a healthcare professional experienced in perinatal mental health.

Self-care

• Rest. Sleep when possible and accept help.
• Nutrition. A diet including fruit, vegetables, protein and whole grains supports healing and, where relevant, breastfeeding.
• Hydration. Particularly important when breastfeeding.
• Gentle exercise. Walking or post-natal exercise once cleared improves circulation and mood.

What surgery can address

A mommy makeover is a combination of procedures addressing the physical changes associated with pregnancy. It typically includes abdominoplasty, breast lift or augmentation, and liposuction, among other possible procedures.

It is individualised

The combination is determined by what is actually present. The procedures address several areas affected by pregnancy, from the breasts to the abdomen.

It addresses what diet and exercise cannot

Some changes do not respond to diet and exercise because they are not fat. Abdominoplasty repairs diastasis recti — separation of the abdominal muscles — and removes excess skin. Neither responds to abdominal exercise; in fact abdominal exercise on a separated abdominal wall can make the appearance worse.

It requires stability first

Surgery is deferred until weight and hormonal status have stabilised, generally at least six months after childbirth or after finishing breastfeeding. Operating before that point risks a result that changes as the body continues to settle.

Maintaining the result

Weight stability

Maintaining a stable weight through diet and regular exercise is the principal factor in the durability of the result. Weight fluctuation alters the outcome.

Skincare

Moisturising, sun protection and following the specific care instructions given support the appearance of scars over time.

Follow-up

Regular review allows the result to be assessed and any concern addressed.

How we quote

Fees depend on which procedures are included and the operating time required, and are set out in writing after consultation.