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COSMETICS ENVOGUE

Bigger Breasts After Tummy Tuck

This is a blog post about bigger breasts after tummy tuck. It’s no secret that getting a tummy tuck can make you feel like you’re on top of the world. The results are amazing and really transform your body, but what about your self-esteem? It’s true that many people who get a tummy tuck are more confident in their bodies than ever before, but what about those who want to enhance their curves even more? Is there anything you can do to get bigger breasts after tummy tuck?

Women often ask us if they can get larger breasts after getting a tummy tuck. This is an understandable question—after all, many women spend most of their lives wishing for bigger breasts, so it makes sense that they would want them after surgery as well. The answer is yes, it is possible to have larger breasts after getting a tummy tuck. However, there are some important things to keep in mind before making any decisions about this procedure. In this guide, we review the aspects of Bigger breasts after tummy tuck, tumescent liposuction breast, breast enlargement after liposuction, and how to get rid of big tummy after c section.

Read on to learn more about Bigger Breasts After Tummy Tuck, breast enlargement after liposuction and how to get rid of big tummy after c section

Bigger Breasts After Tummy Tuck

Bigger breasts after tummy tuck

When it comes to body contouring procedures, a tummy tuck (abdominoplasty) is ideal for smoothing and tightening the lower abdomen. For patients who have excess skin or tissue of the upper abdomen, however, a reverse abdominoplasty can smooth and lengthen the torso while also adding volume to the breasts.

Board Certified Plastic Surgeon Dr. James Namnoum has earned a reputation for using his considerable skill and artistic approach to consistently deliver reverse abdominoplasty results that appear to naturally enhance a patient’s unique figure.

What is a Reverse Abdominoplasty?

Reverse abdominoplasty is a procedure indicated when skin laxity is confined largely to the upper abdomen and a tight cleavage of the breasts is present. It is a powerful procedure for lengthening and rejuvenating the abdomen and is ideally combined with a breast lift and augmentation.

The extra tissues of the upper abdomen can be used to increase the breast volume with natural skin and fat, thereby avoiding an implant for volume improvement. Reverse abdominoplasty enables a resetting of the breast position on the chest, raising a low breast and improving the length and aesthetics of both breasts and abdomen.1,2

Who is a Candidate for Reverse Abdominoplasty?

The ideal candidate for a reverse tummy tuck is someone is troubled by excess skin and fat on the upper abdomen. Additionally, women who wish to add volume and fullness to their breasts may also benefit from this procedure.

Candidates for reverse abdominoplasty should be in good overall health, be non-smokers, and should have realistic expectations about what can be achieved with this surgical procedure.

The Reverse Abdominoplasty Procedure

Unlike a traditional abdominoplasty, the reverse abdominoplasty does not impact the tissues and muscles of the lower abdomen. During this procedure, Dr. Namoum begins with an incision under the breasts, elevating the skin of the abdomen. At this time, he may also tighten the upper rectus muscles and remove any excess fat using liposuction.
For patients who wish to enhance their bust, Dr. Namnoum can use excess skin and tissue from the upper abdomen to augment the breasts, adding volume and shape. Many patients also choose to undergo a breast lift (mastopexy) at the same time as their reverse abdominoplasty.3

Recovery After Reverse Abdominoplasty

After a reverse tummy tuck, it is normal for patients to experience some bruising, swelling, and discomfort for the first 10-14 days. Dr. Namnoum will prescribe pain medications to keep discomfort to a minimum, and patients will wear a special surgical bandage or compression garment for the first week of their recovery. Most patients are able to return to work one to two weeks after their reverse abdominoplasty procedure, though Dr. Namnoum encourages patients to avoid strenuous exercise or physical activity for at least the first six weeks.

Reverse Abdominoplasty Results

Patients will notice that their upper abdomen is smoother and tighter and that their breasts are fuller immediately following their reverse abdominoplasty. The full benefits of this procedure will be noticeable a few months after surgery, when swelling has been resolved. Patients can expect a thin horizontal scar to remain after their reverse tummy tuck, though Dr. Namnoum will carefully place his incisions so that scarring is hidden within the breast crease.

weight gain after tummy tuck pics

Woman with her hands over her bellybutton after experiencing weight gain after her tummy tuck procedure.

A tummy tuck at our Louisville, KY, plastic surgery center can be a transformative procedure, but excessive weight gain can minimize the longevity of your results. Many men and women worry that major lifestyle changes could impact their plastic surgery investment. All humans have natural weight fluctuations, but it’s important to know the connection between tummy tucks and weight gain. In this blog post, we will discuss every tummy tuck patient’s biggest fear—weight gain after surgery—and what to do to prevent it.

Why do patients gain weight?

There are many reasons why patients gain weight after tummy tuck surgery. Understanding the reasons discussed here is the first step in preventing weight gain.

Lifestyle

Regardless of how many cosmetic procedures you get, the cornerstone of maintaining a slim figure is leading a healthy lifestyle. Of course, we all have cheat meals and lazy days every so often, but establishing healthy habits is essential to looking and feeling your best. There are no replacements for a balanced diet and regular exercise.

Hormones

Your hormones fluctuate monthly and throughout the course of your life from puberty to adulthood. When your hormones are unbalanced, your weight can be dramatically affected. If you are doing everything you can to live a healthy lifestyle, and you still are gaining weight, talk to your doctor and he or she will be able to give you tips to balance your hormones and get you back on track.

Stress

Stress often causes people to sleep less and eat more—both of which play major roles in weight gain. Additionally, stress can cause hormonal issues like the ones mentioned above, with the result being that you store extra fat. You can find many ways to combat stress—exercise, medication, journaling—so it is important to find one that works for you.

Post-Surgery Fluid Retention

Sometimes after surgery water is retained in the areas between your organs, which can lead to a bloated appearance. This fluid retention can be localized—like swollen hands and feet—or it can be more generalized to give the appearance of overall weight gain. Staying active and following proper post-op instructions will help remedy this type of fluid retention.

Where do patients gain weight after a tummy tuck?

During body contouring procedures like a tummy tuck, fat cells are eliminated from the body and cannot return. Because of this, patients may gain weight in other places like the buttocks, legs, arms, and breasts. Patients also sometimes gain weight around their organs, and neither a tummy tuck nor liposuction can remove these fat cells.

What are the consequences of gaining weight after a tummy tuck?

You will be able to maintain your tummy tuck results if you have minor weight fluctuations, so gaining 10 to 15 pounds should not present significant issues. However, gaining weight can be a slippery slope, and excessive weight gain will surely compromise your results. Weight gain over 15 pounds can cause skin and abdominal muscles to stretch and create a belly bulge.

If the weight gain continues, you may need a tummy tuck revision. A revision can be a more complicated surgery, so I advise all my patients to stick to a healthy lifestyle instead, so they can enjoy their results for years to come. Tummy tuck results can be long-lasting when performed in conjunction with good diet and exercise.

Extended tummy tuck

Excess fat in the lower abdomen is a common complaint for both men and women.  A tummy tuck or abdominoplasty is designed to remove the skin a fat from the belly button to the pubic area by placing an incision below the bikini line.  The abdominal muscles are tightened to narrow your waist and often liposuction is done on the flank and hip areas to trim your body further.  There are many reasons why tummy tuck procedures, also known as an abdominoplasty, have increased 87% from 2000 to 2014. Advances in surgical methods and safety measures have made it possible for more men and women to achieve a tighter, more shapely midsection in cases where:

  • Extreme amounts of weight loss have led to excess skin
  • Pregnancy has resulted in stretched skin and weakened abdominal wall
  • Healthy diet and exercise regimens have not achieved your desired shape

Women have the additional concern of childbirth which significantly stretches the abdominal muscles. When there is good skin tone, no stretch marks, and a limited amount of fat, liposuction alone is usually the best option. However, when stretch marks are present in addition to abdominal muscle laxity, a tummy tuck remains the best option. In this procedure, the incision is kept low below the “bikini line” and a large ellipse of fat and skin is removed. The belly button is resutured in its original place and the abdominal muscles tightened to give an hourglass shape. This procedure can be combined with liposuction to further sculpt the body.  Newer techniques use progressive tension sutures or Tissue Glu to eliminate the need for a drain making recovery much easier and quicker.

Bikini Incision

Dr. Burns is know for his low scar bikini incision designed to hide the scar below the underwear or swimsuit line.  The bikini incision hides the incision allowing patients to wear swimsuits and underwear without showing their tummy tuck scar.

In an extended abdominoplasty, the incision will generally extend beyond the hip bones to include some of the lower love handle area.  The extended incision will allow more tissue to be removed.  This approach is ideal for heavier patients who require more contouring or massive weight loss patients with significant extra skin.

Dr. Burns is one of the nation’s leading body contouring Board Certified Plastic Surgeons and practices a short scar bikini line incision technique where you scar will be hidden in most undergarments or swimwear.


Adjustable Breast Compression

Special postoperative breast garments have been specifically designed to allow easily adjustable compression. If the compression is too slight, there is a risk of subcutaneous bleeding. If the compression is too tight, the patient may experience pain or difficulty breathing. The solution to this situation is to use an adjustable compression garment so that the patient can easily readjust the compression to the maximum comfortable level at any time.

Postliposuction breast compression should be maximal for the initial 12 to 18 hours. The day after surgery, while there is some drainage, the compression is adjusted to a more moderate level. Ultimately, after all drainage has ceased, the compression is again adjusted to a minimal level but still sufficient to provide comfort and support.

Trimodal Compression

The term trimodal compression is used to emphasize that three sequential and decreasing degrees of compression are used after breast liposuction.

The first 12 to 18 hours after breast liposuction requires the maximum compression that the patient can tolerate comfortably. This relatively intense compression is necessary to minimize the risk of postoperative hematomas and to limit the amount of bruising.

After the initial phase, continuous, moderately firm compression is required to optimize drainage and minimize postliposuction edema. This intermediate degree of compression is maintained for at least 48 hours and for 24 hours beyond the time when all drainage has ceased.

Beyond the 24 hours after all drainage has stopped, compression is needed to minimize the risk of seromas and to optimize patient comfort. At this point, only a mild to moderate degree of compression is required. The intensity of the compression should be selected to maximize patient comfort. This mild to moderate compression is typically maintained 5 to 7 days or more. Maintaining compression more than a week after surgery can be at the patient’s discretion.

Subsequently, many patients prefer to use a sports bra for several weeks until a regular bra can be worn comfortably.

A compression garment or binder must be not only comfortable but also securely applied to prevent slipping from its intended location. An unsecured abdominal binder placed around the chest and over the breasts can readily shift position during sleep or normal ambulatory activity. The weight and mobility of the breasts, the funneled shape of the thorax, and the narrow girth of the waist cause the entire dressing to migrate toward the hips (Figure 38-10).

Years of experience and numerous modifications have helped me to develop an effective, comfortable, and reliable system that uses absorptive pads, a spandex torso garment, and highly compressive abdominal binders (Figure 38-11).

The HK Breast-Torso Garment permits comfortable, adjustable, secure, high-pressure compression for breasts, abdomen, or hips and waist after tumescent liposuction. Because of the prolonged local effect of tumescent anesthesia, most patients require no postoperative analgesia other than acetaminophen (Tylenol) (Figure 38-12).

The garment’s degree of compression should be as tight as possible but still comfortable. If the patient is uncomfortable, the degree of compression should be adjusted.

The greatest tolerable compression is maintained until the next morning, when the pads are removed while the patient takes a shower. After showering the patient applies new pads every 12 hours until all drainage has ceased, usually less than 48 hours after surgery.

breast enlargement after liposuction

Some studies have indicated that liposuction may cause breast enlargement. Fat redistribution to the upper body as a compensatory mechanism after liposuction has also been reported.

To evaluate the possibility of secondary breast hypertrophy and fat redistribution after liposuction, breast size and upper body measurements were obtained and compared for women who did not gain weight postoperatively.

Eighty-two women who underwent cosmetic surgery, not including breast surgery, were enrolled in this prospective controlled study. Participants represented 1 of 3 procedure groups: cosmetic surgery not including liposuction (n = 24), liposuction (n = 41), and liposuction combined with abdominoplasty (n = 17). Breast measurements were obtained from standardized lateral photographs matched for size and orientation. Results were compared among the study groups.

Postoperatively, there were no significant changes in mean body weight among the study groups. No significant increases in upper pole projection, breast projection, or breast area were found in patients treated with liposuction alone and those who received liposuction plus abdominoplasty. Upper body dimensions were unchanged except for a significant (P 1500 mL.

Results indicate that neither liposuction nor abdominoplasty produces secondary breast enlargement. Upper body dimensions are unchanged, consistent with findings of a previous study and contrary to the theory of fat redistribution.

Many researchers have claimed that breasts enlarge after liposuction,1,,,,-6 and van der Lei et al6 recommend informing prospective patients about this possibility. However, this phenomenon has not been evaluated by comparing standardized breast measurements.

In a widely publicized study in 2011, Hernandez et al7 claimed that fat is redistributed from the lower body to the upper body after liposuction. In previous research,8 the author of the current study challenged their conclusion, finding no evidence of fat redistribution to the upper body after liposuction alone or in combination with abdominoplasty, but did not specifically evaluate possible postsurgical changes in breast size. This study was undertaken to investigate whether liposuction causes breast enlargement. Possible compensatory changes in upper body dimensions also were evaluated, as in the previous study.8

Methods

Patients

This prospective study was conducted in consecutive patients who underwent plastic surgery between January 2012 and July 2013 at the Surgery Center of Leawood, a state-licensed ambulatory surgery center. Institutional review board approval was obtained from Institutional Review Board Services, accredited by the Association for the Accreditation of Human Research Protection Programs, Inc. Eligibility criteria were as follows: (1) women who underwent cosmetic surgery that did not involve breast surgery, (2) consent for breast photographs, (3) availability of postoperative photographs taken at least 3 months following surgery, (4) no breast surgery between surgery and the dates of any postoperative photographs, and (5) no pregnancy during the study period. Patients who underwent liposuction simultaneously with another procedure, such as abdominoplasty, were included. Also included were patients with existing breast implants. Each patient was weighed before and after surgery on the same hospital scales.

Of the 102 consecutive women who underwent cosmetic surgery that did not involve a breast procedure, 12 declined to participate in the study. Seven others were unavailable for follow-up appointments at least 3 months after surgery. One patient had a breast procedure within 3 months of surgery, rendering her ineligible. Therefore, the study population comprised 82 patients (80.4% inclusion rate). These patients were categorized into 3 study groups: the control group of patients whose procedures did not include liposuction (n = 24), patients who had liposuction alone (n = 41), and those who had liposuction plus abdominoplasty (n = 17). “Liposuction/abdominoplasty” was defined as liposuction of the abdomen and flanks in combination with abdominoplasty. Most liposuction/abdominoplasty patients also underwent liposuction of the thighs and medial knees.

Surgery

All liposuction procedures were performed with the Lysonix 3000 ultrasonic system (Mentor Corp, Santa Barbara, California) and a superwet technique. All surgery was performed by the author. Total intravenous anesthesia was administered by an anesthesiologist or certified nurse anesthetist.9 All abdominoplasties were primary procedures and included plication of the rectus fascia.

Photographs

To ensure standardization,10 all patients were photographed in the same room, with the same background and lighting. All photographs were digital images taken by the author with the same Nikon D80 digital camera and Nikon 60-mm fixed focal length lens (Nikon Corp, Tokyo, Japan), calibrated by having each patient hold a ruler in 1 of their photographs. All upper body photographs were obtained while patients were standing with arms resting at their sides (demonstrated in Figures 1 and 2). Lower body photographs were taken with the arms raised (demonstrated in Figures 3 and 4). Lower body measurements were not compared in this study but were evaluated previously.8

Patient 1. This 39-year-old woman’s upper body was photographed before (left) and 4 months after (right) liposuction of the lower body (abdomen, flanks, thighs, and knees). The total liposuction volume was 3150 mL. Preoperative weight was 178 lb, and postoperative weight was 170 lb. The 8-lb weight loss was only slightly greater than the 6 lb expected from the fat removal (3150 mL; 1 L = 2 lb), essentially rendering her calorically neutral after surgery. The upper body measurements showed no evidence of fat redistribution. Photographs were matched for size and orientation. (Photographs of this patient’s lateral breast and lower body are shown in Figures 214535801-4.)

Patient 1. Lateral breast measurements for this 39-year-old woman, obtained before (A) and 4 months after (B) liposuction, showed no evidence of breast enlargement posttreament. Photographs were matched for size and orientation. MPost, maximum postoperative breast projection.

Patient 1. Lower body photograph of this 39-year-old woman before liposuction.

Patient 1. Lower body photograph of this 39-year-old woman 4 months after liposuction. This image was taken simultaneously with the upper body and breast photographs (Figures 1 and 2). All lower body dimensions were reduced from preoperative measurements. This photograph was matched with Figure 3 for size and orientation.

Measurements

Horizontal breast measurements and area calculations were obtained from standardized lateral photographs matched for size and orientation using the method previously published11 and Canfield Mirror 7.1.1 imaging software (Canfield Scientific, Inc, Fairfield, New Jersey) (Figure 2). Measurements were taken from frontal photographs to determine any possible changes in upper body dimensions after liposuction.8 The areas measured included shoulder width, bihumeral width, and upper abdominal width at the same vertical level (Figure 1). Although not specific, these shoulder and mid-humeral measurements are expected to indicate an increase in subcutaneous fat volume of the arms, triceps, and midaxillary areas,8 which are anatomic sites thought to be affected by fat redistribution.7 To investigate the possibility of selection bias, excluded patients were compared with eligible participants.

Statistical Analysis

Statistical analyses were performed with SPSS for Windows (version 21.0; SPSS, Inc, an IBM Company, Chicago, Illinois). Mean differences between groups were determined by 1-way analysis of variance (ANOVA), and mean differences between matched pairs before and after surgery were assessed with paired t tests. Pearson correlations were computed. For multiple comparisons, statistical significance was defined as P < .01. A power analysis was performed to determine adequate sample sizes. To achieve 80% power at α = .05, sufficient to detect a moderate treatment effect (F = 0.40) across 3 groups,12 66 subjects were required.13

Results

There were no significant differences between treatment and control patients with respect to mean age, follow-up time, body mass index, and change in weight (Table 1). The mean follow-up period was 5.6 months (range, 3-19 months). The overall comparison of participants and nonparticipants showed no significant differences in these parameters or in liposuction volume or flap resection weight (data not shown). No patient with existing breast implants developed a clinical capsular contracture or a known implant deflation during the study. The mean weight change for the control group was a gain of 0.73 lb after surgery. Liposuction patients lost an average of 0.66 lb, and liposuction/abdominoplasty patients lost an average of 3.91 lb (difference not statistically significant).

Pre- and postoperative right breast measurements were compared among the 3 study groups (Figures 514535801145358011453580114535801-10). Right and left breast data appear in Tables 2 and 3. There were no significant changes in breast measurements among control patients, with the exception of a slight increase (0.23 cm) in mean postoperative right breast projection (P < .01). There were no significant changes in breast measurements after either liposuction or liposuction/abdominoplasty (Figures 5 and 6). Mean breast area measurements also remained unchanged (Figure 7, Table 2).

Right breast projection before (green) and after (blue) surgery in the control group (cosmetic surgery that did not include liposuction; n = 24), the liposuction group (n = 41), and the group with liposuction plus abdominoplasty (lipo/abdominoplasty; n = 17). The mean follow-up time was 5.6 months (range, 3-19 months). Data are presented as means ± standard deviation (bars).

Right breast upper pole projection before (green) and after surgery (blue) in the control group (cosmetic surgery that did not include liposuction; n = 24), the liposuction group (n = 41), and the group with liposuction plus abdominoplasty (lipo/abdominoplasty; n = 17). The mean follow-up time was 5.6 months (range, 3-19 months). Data are presented as means ± standard deviation (bars).

Right breast area before (green) and after surgery (blue) in the control group (cosmetic surgery that did not include liposuction; n = 24), the liposuction group (n = 41), and the group with liposuction plus abdominoplasty (lipo/abdominoplasty; n = 17). The mean follow-up time was 5.6 months (range, 3-19 months). Data are presented as means ± standard deviation (bars).

Shoulder width before (green) and after surgery (blue) in the control group (cosmetic surgery that did not include liposuction; n = 24), the liposuction group (n = 41), and the group with liposuction plus abdominoplasty (lipo/abdominoplasty; n = 17). The mean follow-up time was 5.6 months (range, 3-19 months). Data are presented as means ± standard deviation (bars).

Bihumeral width before (green) and after surgery (blue) in the control group (cosmetic surgery that did not include liposuction; n = 24), the liposuction group (n = 41), and the group with liposuction plus abdominoplasty (lipo/abdominoplasty; n = 17). The mean follow-up time was 5.6 months (range, 3-19 months). Data are presented as means ± standard deviation (bars).

Upper abdominal width before (green) and after surgery (blue) in the control group (cosmetic surgery that did not include liposuction; n = 24), the liposuction group (n = 41), and the group with liposuction plus abdominoplasty (lipo/abdominoplasty; n = 17). The mean follow-up time was 5.6 months (range, 3-19 months). Data are presented as means ± standard deviation (bars).

Breast Dimensions Before and After Surgery (N = 82)

Upper Body Dimensions Before and After Surgery (N = 82)

Upper body dimensions did not change significantly for control patients after surgery (Figures 814535801-10). Upper abdominal width decreased significantly (P < .01) after surgery in patients treated with liposuction/abdominoplasty (Figure 10, Table 3).

A subset of 53 patients who did not have existing breast implants was evaluated separately (data not shown). Similar to the larger group that included women with breast implants, there were no significant changes in any measurements after liposuction alone and a significant (P 1500 mL (Figures 11453580114535801-4) also had no significant changes in breast or upper body dimensions after liposuction; a reduction in upper abdominal width (P < .01) was recorded after liposuction/abdominoplasty. No significant correlations were observed for any of the following parameters: age, follow-up time, body mass index, and change in either breast or upper body dimensions.

Discussion

Theory of Fat Redistribution

Proponents of fat redistribution theorize that the body forms new fat cells in untreated areas to compensate for fat cells lost after liposuction.7 Such a mechanism would require a memory for the original allotment of adipocytes and an ongoing “inventory” of site-specific fat cell numbers, directing different anatomic areas to manufacture new fat cells as needed. Advocates of this theory concede that their findings have not been reproduced by other investigators, and such a mechanism has no known physical explanation.7

A landmark study of carbon-14 isotope incorporation in genomic DNA demonstrated that a homeostatic mechanism maintains adipocyte numbers, with a constant 10% renewed annually, and that this rate does not vary by age or body mass index in adults.14 This finding confirms earlier work indicating that adipocyte hypertrophy accounts for increased fat volume in conditions of moderate obesity.15,-17 With weight loss, fat cells shrink, but their absolute number does not change.18,-20 The quantity of fat cells is reduced only by liposuction or other fat resections (eg, abdominoplasty).21 This adipocyte theory21,22 is the basis for the efficacy of liposuction in permanently improving body proportions (Figures 11 and 12). If this concept were false, liposuction would represent an unattractive therapeutic option. Most women would be unwilling to trade fat from the thighs for fat in the arms, axillary areas, and shoulders, which might create an unfeminine “linebacker” appearance.8

Illustration of the effects of weight loss and gain on body shape before liposuction. Fat cells enlarge and shrink with weight gain and loss, but do not change in number. Body disproportion is not affected.

After liposuction, the number of fat cells has been permanently reduced in treated areas. The patient is trimmer in those areas than she would have been without liposuction, whether she gains or loses weight. There is no effect on untreated areas.

The conclusion by Hernandez et al7 supporting fat redistribution is undermined by methodological deficiencies8 that include a limited sample size of 14 surgical patients, imprecise measurement techniques, nonsignificant changes, and a cohort that gained weight after surgery.

Weight Change After Liposuction

Caloric neutrality is essential in any study of fat change after liposuction.8 If weight increases postoperatively, it is not possible to distinguish a theoretic volume expansion caused by fat redistribution from an expected volume increase relating to additional fat deposition due to weight gain. In the present study, patient weight was recorded rigorously by nurses, and the same hospital scales were used for all patients. There was no reliance on patient estimates, which are known to be inaccurate. Postoperative changes in mean body weight among control patients and liposuction patients were <1 lb (not statistically significant). The mean reduction of 3.91 lb after abdominoplasty was similar to the average flap weight of 4.15 lb. Therefore, measurement data are not influenced by a significant postoperative weight change that might cause an overall increase or decrease in adipocyte size and fat volume. The significant (P < .01) reduction in upper abdominal width after liposuction/abdominoplasty may be explained by the more effective fat reduction achieved by combined modalities.

In previous studies showing a postliposuction increase in breast size, patients gained weight after surgery.1,-3,5,6 A single study4 showed an increase in breast size without documented weight gain; however, patients’ weight estimates were provided in person or by telephone. Direct weighing was not performed.

Possible Hormonal Influence

Although postoperative increases in breast size may be explained by weight gain, some investigators1,-3,5,6 postulate a hormonal mechanism for increased breast size after liposuction. Fat cells are known to produce estrogen. In postmenopausal women, adipocytes produce most of the circulating estrogen5; they also produce androgens. Proponents of a hormonal influence reference site-specific differences in the production of estrone vs androgens from their precursor, androstenedione.22 In their study of 4 women and 2 men, Killinger et al22 reported that the conversion of androstenedione to estrone was greater in fat cells harvested by liposuction from the upper thigh, buttock, and flank than in abdominal fat cells. According to this hypothesis, if abdominal fat is preferentially removed by liposuction, the relative amount of circulating estrogen is increased, causing breast enlargement.3,5,6 No published studies include hormonal assays to support this theory. Moreover, most patients treated with abdominal liposuction also receive treatment of the flanks1,,,,-6 (sometimes labeled the “hip rolls”)3,5 and thighs, which equalizes any possible differences in estrone production by aspirated fat cells. Liposuction/abdominoplasty removes a greater volume of fat from the abdomen than liposuction alone.8 The lack of breast size increase in the present study provides additional evidence that preferential removal of abdominal subcutaneous fat does not create a hormonal imbalance leading to breast hypertrophy.

In an evaluation of 15 women and 14 men, Anderson et al23 demonstrated no effect of either estrone or dihydrotestosterone on adipocyte mass through proliferation of preadipocytes, suggesting that differences in plasma levels of these sex hormones are irrelevant with respect to fat deposition. In postmenopause, estrogen no longer has a major role as a circulating hormone but rather functions locally in tissue sites where it is formed.24 Scarborough and Bisaccia2 reported no correlation between subjective change in breast size and supplemental hormone replacement or menstruation. Finzi4 found no effect of menopausal status on patient-reported breast enlargement after liposuction.

Limitations of Existing Studies

The studies demonstrating breast enlargement after liposuction1,,,,-6 relied on subjective patient assessments of change in weight, breast size, and bra cup size. None included objective measurement of the breasts. Of course, reducing abdominal girth improves the ratio of breast/abdominal projection, which may be interpreted by patients as an increase in breast size.25

The Measuring Device

Obtaining measurements of body and limb circumference seems appropriate when studying changes in body dimensions.26 However, these physical measurements have well-known limitations: they are affected by differences in the level of measurement on the trunk or limb, the tension applied to the measuring device, and how level the measuring device is held. These factors create variations in subsequent measurements as well. Moreover, interobserver error is introduced when measurements are obtained by different individuals. Photographic measurements are convenient; taking photographs requires only 1 to 2 minutes of the patient’s time and is typically done as a matter of course to document results. Measurement software facilitates matching photographs for size and orientation (Figures 11453580114535801-4)8,11 and corrects for any differences in magnification or tilt in the before and after photographs. Measurements can be made using a cursor on a computer monitor at the investigator’s convenience. These factors maximize compliance and, therefore, inclusion rates. In the present study, an inclusion rate of 80.4% was achieved, meeting the benchmark for evidence-based medicine27 and ensuring that the reliability of the findings is not compromised by missing patient data.

Sample Size

The initial report of an increase in breast size after liposuction included 5 women who gained between 5 lb and 7 lb after surgery.1 In a recent study that reported breast hypertrophy after application of aminophylline cream to the thighs, the investigators evaluated 7 weight-stable patients but did not include a control group.28 The study by Hernandez et al7 that reportedly showed fat redistribution included 14 nonconsecutive surgical patients. These small sample sizes increase the likelihood of capturing a cohort of patients who gain weight after surgery. Large sample sizes are essential to avoid type II (false-negative) statistical errors.29

The number of exclusion criteria must be minimized to avoid selection bias.27 Women who had existing breast implants (ie, inserted during a previous operation) were included in the present study because it is presumed that the size of breast implants will not change in the absence of a complication. Data analyses in which these patients were excluded produced the same findings.

Follow-up Time

The follow-up period must be long enough to ensure that the temporary effects of tissue swelling do not influence the data, but not so long as to jeopardize the inclusion rate.30 It is well known that elective cosmetic surgery patients are not typically motivated to participate in long-term follow-up for research purposes.31 Previous measurement studies have shown that swelling has subsided at 3 months and is unlikely to affect measurements.30,32

The mean follow-up period (5.6 months) and range (3-19 months) in the present study correspond almost exactly to those of a study3 in which breast size reportedly increased after liposuction. This range slightly exceeds the maximum 18-month follow-up periods of the 2 original studies in which breast hypertrophy was reported after liposuction.1,2 The other 3 studies in which breast size increased after liposuction included longer maximum follow-up times,4,-6 up to 4 years.6 The negative findings of the present study do not rule out a hypothetic fat redistribution mechanism that might occur over a longer period. No published study included weight-stable patients who were measured with a reliable device for longer follow-up periods (ie, >1.5 years). As noted by van der Lei et al,6 longer follow-up times may introduce confounding effects of aging.

how to get rid of big tummy after c section

Hey, girls! I am back with another post! Today, we would be talking about how to reduce tummy after cesarean delivery. Delivery can be a problem if you have to get C-section. You may deal with inflammation, wound infection and back aches after the C-section. However, apart from all these problems, weight gain can be a common problem that every woman who goes under C-section needs to deal with. You may observe pouch-like area near your belly, which is extremely difficult to get rid of after the delivery.

Ways to Reduce Tummy After Cesarean Delivery

However, in order to reduce tummy soon after your cesarean delivery, here are few simple things you should consider.

1. Use a tummy binder

Using a tummy binder is a common way to get a flat tummy after the C-section. The post C-section tummy binder is made of an elastic cloth or a muslin cloth which works more like a bandage. Using this belt can help to push the belly inside, thus, promoting flat belly after few days of use. You can do this only after 2 months of getting the surgery so that the tissues can heal faster.

2. Breast feeding

One easy way to get rid of the extra fat around the tummy is breast feeding. Breast feeding will not only help to develop a bond with your baby but it can burn a lot of calories, thus, getting rid of the extra fat post the pregnancy. It is important to breast feed your baby for at least 6 months so that it melts off the belly fat soon.

3. Drinking lots of water

Drinking lots of water can not only help to hydrate your body but, surprisingly, it can also help to flush out the excess fat from the system. Drinking water is essential after C-section, as it is not only helpful in maintaining the fluid balance but prevents you from over eating as well. Keeping your body hydrated can help to speed up the healing process.

4. Drink lemon water

Drinking lemon water after C-section is the safest way to detox and get rid of the excess belly fat. Take some lukewarm water and add some lemon juice and honey to it. Mix together and drink this water in the morning. You should drink lemon water only once in a day. A combination of lemon and honey with lukewarm water can help to melt the fat and reduce tummy after cesarean delivery easily.

5. Eat right

A woman generally needs 300-500 calories in order to keep her body healthy and function properly. You should be consuming lots of fruits, eggs, and milk in order to meet the minimum requirement of your body. Because you cannot perform normal workouts after C-section, you should be very cautious during this phase. During the first six months of pregnancy, your body secretes pregnancy hormones which allow your body to gain weight very easily. So, it is always good to stay away from junk food and gorge more on fruits and veggies.

6. Use a postpartum support belt

Using a postpartum support belt can prove extremely good in treating flabby stomach. Using postpartum support belt helps to tighten the abdominal muscles, thus, reducing the stomach fat and also reducing the back pain. The postpartum belt is preferable to reduce tummy after cesarean delivery. This is especially good for those who went through C-section. Make sure that you use the belt only after 2 months after the delivery. You can remove the belt while eating and sleeping.

7. Go for walking

You should prevent extensive workout as it may take a toll on your stomach and muscles. You should start walking regularly for 30-40 minutes, 5-6 months after the delivery. Walking is a low impact workout which helps to boost metabolism and also burn the extra fat in the body. It also helps in increasing the energy, thus, preventing the body fat to get stored in the body.

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