Thursday, July 24, 2008

"Mummy Makeover" ... I

“A Mom Makeover!”

Sounds trendy doesn’t it???

Well not really, it’s new packaging of the procedures already being done, as we shall discover in the process of this blog and the next.

Why the mom makeover at all?

The woman being the one to create life, goes through many changes physically during the process of pregnancy, giving birth & nursing the child. In a way, it is a sacrifice she makes to create and bring forth a new life.

But, the question still remains, why the makeover at all. What are the changes that occur which need to be corrected.

Doc, I jus saw myself in the mirror today and I was shocked, as I couldn’t recognize the person I saw in the mirror. It was definitely not me..!!!

This is a common complaint women come to us with. During their pregnancy, the mother and everyone around are concentrating on the eating, weight and the unborn child’s well being. After birth it is again the child who is the center of attention, after that till the child starts going to play school, the mother is totally neglecting herself. Then one fine day when she has a little free time from kids and family, she looks at herself and cannot recognize the person in the mirror.

It is not intentional, that this happens. It’s just how things are prioritized in life. I’m not saying that we do not need to give attention to the child during that period. Just that, a little bit of attention to the mother during the pregnancy, childbirth and post birth period, will go a long way in her not having to feel that way a few years down the line.

So what exactly am I talking about here?

To simplify the understanding of what needs to be done, let me first start by enumerating and discussing few of the issues that form the basis of the problems to be corrected in a Mum Makeover.

  1. The Tummy: The abdomen, especially the lower abdomen is the area which bears the most insult during pregnancy. Because of the growing womb, the skin is stretched, the muscles are stretched, and there is collection of fat because of the weight gain. Post childbirth, the skin stays loose, has lot of stretch marks, there is a prominent bulge in the lower abdomen because of the loose muscles. All these are compounded by lack of physical activity concentrated to the specific area. Also, with more women now going in for cesarean sections, the lack of activity in that area get further delayed.

  1. The Hips: This area is genetically programmed to carry more fat in a woman (the pear shape). More so during pregnancy and post pregnancy. This is genetically the reserve, which the woman accumulates during pregnancy. Combined with less physical activity in the immediate post partum period, tends to get worse.

  1. The Breasts: The breasts also bear equal brunt of the pregnancy and post delivery period. During pregnancy and lactation there is development of the milk glands to produce milk for the newborn and hence as they develop they replace the fat that is present in the breast. Once the period of breast-feeding is over, the glands get back to their pre pregnancy state, but the lost fat doesn’t come back and that is the reason for the breast looking empty and sagging. Also because of the stretch marks on the skin of the breast, the skin doesn’t shrink back to the reduced volume giving it the appearance.

  1. The Vagina: Post childbirth, the vaginal canal is stretched and like any muscle that is stretched a lot, it needs toning to bring it back to its normal size and tone. In fact in the west this has been used as a punch line to ask people to go in for caesarean sections… “ Have your child the C sec way and keep your passage the honeymoon way”. But that is not required, the vaginal passage was physiologically meant to stretch and contract. But a few things have to be kept in mind, as we will discuss later on in this blog.

  1. The Face: Post pregnancy and childbirth many women tend to have pigmented patches on their faces called “ Melasma” which just persists even after childbirth. This occurs due to hormonal changes during pregnancy. Also some patients might have a double chin or a more rounded face as part of the generalized weight gain seen during this period.

Now that we know what are the few changes, which occur during the period starting from getting pregnant to one realizing that their whole body image has changed, is there something we can do to reduce these insults if not prevent them altogether?

The good news is YES…!!! There are things, which one can do during pregnancy and in the immediate period following childbirth to help prevent or at least reduce the changes that are occurring in the body.

Pregnancy Care:

The whole aim of the “pregnancy care” concept is to help the mother to be to take care of her body by doing small things to prevent future problems. The main problem during pregnancy is the weight gain and the increasing abdominal girth. When this rapid weight and circumference gain is more than what a person’s skin can tolerate, the dermis which is the supporting layer of the skin ruptures leading to stretch marks. So to prevent stretch marks the best thing that one can do it just spend 10 minutes each in the morning and night out of 24 hours to do a little something to help keep the skin supple to prevent stretch marks. The areas to be concentrated on are the abdomen (more so the lower abdomen), the breasts, the buttocks and the thighs.

The best way to keep the skin supple is to moisturize it. It could be with the help of oils or body lotions. Just take 10 minutes out of your daily schedule to gently massage the areas with a body oil or body lotion. This when done over the period of the pregnancy will make the skin supple and allow it to stretch easily as the mother gains weight and the abdomen gains circumference. This is true for the breast as well as other areas as mentioned before.

This simple step can prevent a lot of the problems later on. Also the second trimester is the most important period to do this because in the last trimester the weight gain and the circumference gain is very rapid and doing it then will not give the skin sufficient time to become soft and supple enough to stretch.

Post Child Birth:

Post delivery the single most important thing a mother can do to help her regain her figure and push her tummy back is the same thing that our grand mothers used to advice. That is the use of a binder or as the grand mothers would advice tying a sari around the abdomen tightly.

This helps in two ways, firstly it is pushing the skin back to its normal position and allowing it to shrink as it normally should and secondly it is also pulling the muscles together to the normal position they should be in. Hence, this when done properly for the next few months will greatly help in one getting back to the pre pregnancy state. Of course if the stretch marks are too bad then the shrinkage might not be to the extent that is desired for, as the skin is like a rubber band broken at multiple places, but even then the muscle toning itself is enough reason for one to use the binder.

This can be done for patients who have undergone C-Sec’s too. After the initial week or two of the healing time for the wound, the binder will help as mentioned above.

The other things that the mother can do are to continue the oil massages to the body and to get into some sort of regular physical activity. Be it morning walks or evening walks or treadmill, etc. I know there would be lot of women shaking their heads n saying… “ What does he know.. He’s not a woman! How do we find time for it? ” But for that, ladies.. let me just say one thing… “Its not easy agreed but if you do it.. it will benefit you. You are preventing a surgical procedure and getting back to how you were and not letting things get out of hand…!” So you work out the math!

As far as the vagina goes, the easiest way to help tone the pelvic musculature to get back to what it was is to do some basic exercises called Kegel's Exercises. The aim of these exercises is to strengthen and fortify the muscle tone of the muscles of the pelvic floor which in turn. It basically involves contracting your pelvic muscles and keeping them contracted for a period of time and doing this in cycles all through the day. The best part of this exercise is that it can be done anywhere and anytime and doesn’t need any equipment.

So now that we know what are the few things one can do to prevent things from getting out of hand and one finally landing up in the so called “ Clutches” of the “Cosmetic Surgeon”, I hope more and more to be mothers will take better care of themselves to prevent or reduce these problems.

As, I will be dealing with the specific surgical management of these problems and the actual “Mummy Makeover”, I think this blog should have been titled…” Tips to prevent a Mom Makeover”.

Happy reading…

Dr.Surindher


Friday, July 11, 2008

Cosmetic Gyneacology - A new concept???

Hi all.....


Today, I'm gonna be talking about a relatively new topic ( at least in the general public's mind) especially in the Indian scenario. I have been getting many queries and emails regarding this, but the common factor in all those being the fact that very little is know about it and there seems to be a lot of confusion regarding the same.


The topic is “Cosmetic Gynaecology”.


Though the procedures that come under this heading have been performed for quite a few years now, the term seems to be recently coined. It basically involves correcting cosmetic problems related to the female genitalia. The procedures which come under this are:

  1. Labioplasty ( Reducing size of the lips)

  2. Hymenoplasty

  3. Vaginoplasty or Vaginal Rejuvenation ( Tightening of the vagina)

  4. G spot amplification


These procedures can be done together or separately or in various combinations depending on the need of the patient. Sometimes certain other urological or gynaecological procedures maybe be combined if there is a associated medical problem.


Let us briefly discuss each of these procedures separately.

1.Labioplasty:

This refers to the procedure by which the labia ( lips) minora most commonly or sometimes both the majora and minora are reduced surgically if they are too long. Many women are bothered about it as they know how it was and they feel it is not the same as time progresses and they feel uncomfortable about it. In normal course the labia minora are smaller and hidden within the labia majora as in the younger age groups. So, this is an attempt to bring it back to the way it was.

It is a relatively simple procedure which can be done under local anaesthesia or regional anaesthesia and the patient can go home the same day.

Some times this maybe be accompanied by fat grafting of the labia majora to increase their volume & give them a more youthful look.


2.Hymenoplasty:

This refers to a procedure of recreating the Hymen. Also called "Revirginization".

Not very commonly a part of the combination of procedures. It involves recreating the thin layer of skin at the vaginal opening to give it an impression of being virginal. Though the fact remains that the hymen can rupture because of many reason other than intercourse. But it is done more for personal and religious beliefs than for medical reasons.

The procedure involves recreating the hymen with the help of tissues in and around the vagina. It is a relatively simple procedure and the patient can go home the same day. The stitches dissolve on their own in a week or 10 days.


3.Vaginoplasty or Vaginal Rejuvenation:

Classically vaginoplasty refers to recreating the vagina in patients with a congenital absence. But here in context of cosmetic gynaecology, it refers to tightening the vagina. Because of child birth and repeated intercourse and lack of exercise the pelvic muscles surrounding the vagina become loose. This may sometimes cause problems during intercourse because of the lack of proper grip for both the partners.

Vaginal tightening can be done with the help of LASER's where the light from the LASER tighten's the mucosa and some part of the underlying muscle. This is a good option if the patient has a decent muscle tone. The other procedure is to surgically tighten the muscles outside the vagina. The procedure is done from within the vagina and the stitches dissolve on their own. The patient can go home the same day or the day after.

This is usually combined with a labioplasty and fat grafting of the labia. The patient can resume normal sexual activity in three to four weeks time. There is an increase in sensations and pleasure during intercourse for both partners.

There are some pelvic exercises which all women can do to naturally tighten their pelvic muscles and delay the need for such a procedure. Some centers also have equipment which will help tighten and strengthen the pelvic muscles.


4.“G Spot” Amplification:

This is a relatively new addition to the procedures. The “G Spot” or The Gräfenberg spot, is a female erogenous zone, which when stimulated leads to high levels of sexual arousal and powerful orgasms.

Though anatomically the “G spot” has not be identified as a distinct physical entity some studies and anecdotal evidences from different women have shown a very sensitive and thickened area in the anterior wall of the vagina. Some studies done also showed this thickening when the women is sexually aroused. Women claimed the experience of a “deeper” orgasm when their her G-spot was stimulated.

Despite professional and scientific criticism and skepticism in general by the public, the G-spot, as a concept, has been widely accepted. Even in India judging by the mails, the awareness has definitely increased.

“G Spot” amplification is an extension of the same concept. As stimulation of the “G spot” is supposed to give greater arousal to the woman, the procedure involves identifying the spot and increasing the size by an injection. It is a relatively safe and simple procedure done as an office procedure. The injection lasts for 6-8 months and can give enhanced pleasure during intercourse by increasing the size of the “G spot” during that time.

But in some cases the results may not be up to the mark because of the difficulty of finding the “G spot”. The injection can be repeated as and when the effect wears off and the woman feels she wants the extra help to get aroused.


The awareness of these procedures and the inquiry regarding the same has increased over the past few years as woman are becoming more aware of their bodies and their own needs. Though there will always be controversies regarding the procedures, like for all other cosmetic procedures the options are there for people who want to get it.

As one of my patient's said... "Doc...I know it's not a necessary procedure... but , Its nice to know we have options !!!!!"


Dr.Surindher

www.cosmesisindia.com