Michelle: Hi. My name is Michelle and I have a question for the doctor. I'm a mother of two babies. My youngest is five months old and I quickly got back into shape as far as losing weight, but all my skin didn't go back quite the way I liked it in my abdomen area, and I was just wondering how long after having kids do you have to wait to have surgery?

Dr. Michael Salzhauer: That's a great question. First of all, let me talk about the problem which is a very common one. After childbirth, many women notice that even though they lose the baby weight, their abdomen just doesn't look the same. The tummy doesn't look tight. It's loose, sometimes there's extra skin, sometimes there are stretch marks, and no matter how much diet or exercise you do, this tummy will never get flat again, and there's a good reason for that. When the uterus expands when you're pregnant, the muscles and skin stretch, and when the muscles separate in the midline, in the middle of your abdomen, that's called the diastasis, and that diastasis or separation never, never gets back to normal without surgery. Almost any woman who's borne children can tell you that their lower abdomen is just a little poochy afterwards. It's never quite the same. Now thankfully, a tummy tuck can correct that. When we lift up the skin, we can sew the muscles back together in the middle with strong permanent sutures. Those sutures are able to re-approximate the muscles and give back the flat stomach that you had before you were pregnant. Your question you ask is a good one about how long you need to wait. There's no hard and fast rule about timing of this procedure. In the old days, let's say 10-15 years ago, the good old days, people would often have tummy tucks at the same time of their cesarean section, and that's not generally recommended anymore for a number of reasons. But assuming that you're healthy and it's okay with your general practitioner and your OBGYN, as soon as five or six months you can undergo an abdominoplasty or tummy tuck. Now, I would caution you that if you plan on having more children, I generally recommend that you wait until you're done having all of your babies because if you get pregnant again, and you can get pregnant after you have a tummy tuck, it's not impossible and it doesn't hurt the baby at all, but it will stretch your skin again, and if your skin gets stretched out again and the muscles separate again, you may need to have a second tummy tuck after you have children. So I recommend that you wait at least until you're through having children, or reasonably sure that you're not having any more children, and then come on in for a consultation and then I can assess your specific needs, Michelle. Now the stretch marks, a lot of people ask me questions about stretch marks after pregnancy. Again, there's no magic cream or formula. There's no laser, there's no pill. There's no treatment that really honestly works for stretch marks other than having a tummy tuck where we incise the skin and take out all the skin that has stretch marks on it. I will caution all my listeners that if there's a website or a television program or a magazine ad that tells you that there's a cream or a portion or a laser that can treat stretch marks, I'm telling you right now you're hearing it from a board certified plastic surgeon, that's all nonsense. There's no scientifically proven method to get rid of stretch marks other than surgically excising them. So don't waste your money on those potions and things because they really don't work, unfortunately. That was a great call, Michelle.

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