We already discussed that the abdominal wall is skin, fat and muscle. Do not confuse this with the abdominal cavity which contains organs. Liposuction and tummy tuck do not involve the organs. You in fact never see the organs. This is important as we discuss who needs a tummy tuck. There is a difference between someone who wants a tummy tuck and someone who needs a tummy tuck. A tummy tuck actually addresses the skin, the fat and the muscle.
Let me explain why some women need a tummy tuck. The Uterus is an internal organ. As it expands during pregnancy it pushes on the abdominal wall. The muscles in the abdominal wall do not stretch. They rotate to the side. You have a left and right six pack muscle. There is a tough band between them in the midline that holds them together. This band runs up and down or vertically from the breast bone above all the way to the pubic area below. This band is attached to the Rectus Abdominis muscles on both sides. As the uterus grows with the baby the band is stretched and the muscles are pushed further and further apart. In other words the band gets wider and wider as the Uterus gets bigger with the baby. The muscles are not torn, they are just separated. The fat layer and the skin layer don’t stretch either the body makes more skin cells and the fat cells get bigger and pad the abdominal wall. The Uterus never leaves the abdominal cavity. It grows and pushes the outside from the inside. It pushes the skinside out. The outside or abdominal wall is still skin, fat and muscle.
With delivery, the Uterus returns to its normal size and position. The moment that child is born the mother is left with excess skin, extra fat and separated muscles. When you have a baby at 19, post-partum metabolism may get rid of the excess skin and fat but not necessarily put the muscles completely back together. This has nothing to do with how much the woman weighs. With each additional pregnancy the muscles are left further and further apart. In addition with each pregnancy the woman is older. With age the likelihood of excess skin remaining after pregnancy is more likely. If you have had two or more kids your muscles are likely separated. If you have twins or greater your muscles are likely separated. If you had your first child after the age of 30 your muscles are likely separated. If you had more than one child and one or more were born after you were 30 your muscles were likely separated and you have excess skin. If you are Hispanic it doesn’t seem to matter. Child birth is particularly rough on Hispanic women’s bodies. It seems that kissing boys separates their muscles and causes excess skin.
If the muscles remain separated. There is absolutely nothing you can do to put them back together. A million sit ups a day will make the muscles stronger but will not put them back in the midline. If your muscles are not in the midline there is nothing there to stop your internal organs from pushing forward, making you look round. Remember the organs are in the abdominal cavity on the inside. It doesn’t matter if your youngest child is now 18. You will never be flat if your muscles were separated by pregnancy. Exercise will not do it. Losing weight will not do it. Liposuction will not do it. Skinny women, trainers, coworkers, x-husbands, regular doctors, your momma and anybody that said “you just need to lose some weight”, needs to apologize. They are wrong! This is an anatomic problem that cannot be improved with losing weight, diet or exercise. These are the people that NEED a tummy tuck. If you have not had a child and you want to be flat you don’t need a tummy tuck. You just want a tummy tuck.