8 Concerns About Pregnancy After Fleur-De-Lis Abdominoplasty (Tummy Tuck) Surgery

Pregnancy following Fleur-De-Lis Abdominoplasty (Tummy Tuck) raises concerns like abdominal muscle stretching, skin changes, scar distortion, discomfort, surgical risks, and implications on the delivery mode.

Tummy tuck procedures are popular for treating skin laxity and contouring the abdomen. Fleur-de-Lis is one type of abdominoplasty,  common among people who have lost massive weight. Whether planned or a pleasant surprise, pregnancy after a Fleur-de-Lis abdominoplasty is also common. But what are some concerns about pregnancy after Fleur-de-Lis surgery? Let’s find out.

Going birth after tummy tuck

What Is Fleur-De-Lis Abdominoplasty

Fleur-de-Lis is a tummy tuck procedure that aims at reducing excess skin and tightening abdominal muscles on the upper and lower abdomen. The procedure is performed by making horizontal and vertical incisions on the abdomen to achieve optimal results. FDL has gained popularity due to the increase in weight loss procedures like Bariatric surgery.

Fleur-De-Lis Abdominoplasty can be classified as both a cosmetic and non-cosmetic procedure. When excess skin and fat on a patient affect their psychological and physical functioning, tummy tuck procedures are considered medically necessary. A FDL tummy tuck has many benefits for a patient, including firmer abdominal muscles that improve posture, and reduced infection risks caused by excess skin.

According to NCBI, “[f]leur-de-lis abdominoplasty can be safely performed with complication rates comparable to those of traditional abdominoplasty techniques. Ideal candidates are patients with upper abdominal skin laxity who may not achieve an adequate aesthetic result with transverse-only excision.” 

Who Is a Good Candidate for FDL Surgery?

When considering FDL surgery, it is important for patients to get professional advice from a FRACS surgeon on whether they qualify for the procedure. The surgeon weighs the patient’s needs, preferences, and existing medical conditions to determine the type of abdominoplasty procedure necessary.

Generally, FDL is a body contouring surgery that deals with excess skin after substantial weight loss through lifestyle changes or bariatric surgery. Patients qualify as good candidates for FDL if they have a normal body mass index and stable weight. Sudden weight fluctuations in a patient can lead to wound dehiscence, which causes surgical site infection.

Non-smokers are preferred FDL candidates since smoking slows down the recovery process. Dr. Benard Beldholm advises that patients quit smoking for at least six weeks before and after FDL surgery to avoid Vasoconstriction and increase the supply of oxygen in the blood.

Mothers are also good candidates for FDL surgery. After multiple pregnancies, the abdominal muscles separate, causing them to stretch. Diastasis recti occurs when the Linea alba is too weak to support abdominal organs and structures. FDL addresses Diastasis recti by tightening and repairing the Linea alba.

Giving birth after fleur-de-lis surgery

How Long Should I Wait to Get Pregnant After FDL Surgery

Surgeons recommend a waiting period of 12 months after FDL surgery for patients to get pregnant. This waiting period gives the incision wound enough time to heal and therefore reduces the risks of complications. Waiting for 12 months also gives the abdominal muscles time to adapt to the FDL surgery results, ensuring ease and comfort throughout the pregnancy.

Changes in the abdomen during pregnancy cause stress on the freshly tightened abdominal muscles, leading to muscle re-separation. It is important for patients to wait for the abdominal muscles to regain strength for improved mobility and posture during pregnancy. In cases where patients get pregnant before 12 months are over, corrective surgery is often sought to maintain the abdominoplasty results post-pregnancy.

Patients should consult their healthcare team for professional guidance before planning a pregnancy post-FDL abdominoplasty. The surgeon assesses the wound healing process, the strength of the abdominal muscles, and overall body health to determine the right timing for a pregnancy.

Fleur de lis tummy tuck scar

Can A Tummy Tuck Incision Be Utilised for C Section?

A Fleur-de-Lis incision can be used in c-section delivery since it is made on the lower abdomen. Using the abdominoplasty incision for C-Section prevents additional scarring on the abdomen, leading to more aesthetic outcomes.

Surgeon performing the C-Section must consider the depth and location of the FDL incision to avoid any complications. In cases where the FDL incision is made below the bikini line to hide the scar, it may be difficult to perform the C-Section since the uterus may be inaccessible.

Patients who prefer C-Section birth are advised to coordinate with their surgeon during FDL surgery for successful surgical planning. When the Surgeon is aware of a patient’s birth plans, he can use a surgical technique that accommodates both the FDL and Caesarean incision.

Giving body time to heal

Will Tummy Tuck Result Be Compromised by a New Pregnancy?

FDL abdominoplasty results will be compromised during pregnancy due to stretching of the skin. Protrusion of the abdomen during pregnancy puts pressure on the Linea alba, which causes abdominal muscle seperation and weakness. Pregnancy also causes hormonal changes that may reduce skin laxity.

More often, the skin does not change back to its pre-pregnancy state requiring the patient to undergo corrective surgery. For long-term results and reduced lower compromise, Dr. Bernard Beldolm, MBBS B.Sc (MED), FRACS, Founder of Body Contouring Surgery Clinic and specialist surgeon, recommend waiting until abdominoplasty results are fully adapted by the body before getting pregnant.

According to a study by Aesthetic Surgery Journal, “[p]atients rated abdominal aesthetic compromise as low as 2.8 out of 10. Only 2 participants underwent revision abdominoplasty, and more than 56% of participants would recommend other women to undergo abdominoplasty even while planning a future pregnancy.”

Another study by NCBI states, “[o]ther than affecting the cosmetic outcomes of the abdominoplasty, pregnancy might affect the mother and the foetus’s health due to impaired flexibility of the abdominal wall.”

Vaginal Birth vs Caesarean Section Delivery

It is ethical for the medical team to put the well-being of both the mother and the child first when considering which mode of delivery to use. Vaginal birth, even though comes with vaginal pain is considered safer due to its reduced risk of surgical complications and its short recovery period. Natural birth can only be performed if there are no notable contraindications.

Caesarean birth is recommended when there is an existing concern surrounding the birth. In cases where the FDL scar is extensive or recent, the wound may reopen causing surgical complications like bleeding. During a C-section delivery, the surgeons can monitor the FDL scar to avoid such incidents from happening. Caesarean birth recovery after abdominoplasty is slow and uncomfortable.

The choice between vaginal and caesarean birth depends on individual preference and existing medical conditions. Open communication between the medical team and the patient is vital for the successful delivery of the child. Patients should point out any pain or discomfort experienced in the abdomen for the right birth recommendation.

Risk Factors and Concerns

There are several risk factors and concerns associated with pregnancy after FDL abdominoplasty. Here are the major ones.

Stretching Of Abdominoplasty Muscles

During pregnancy, the body undergoes changes like belly protrusion and weight gain due to hormonal changes. It is common for pelvic floor muscles to stretch in an effort to accommodate the foetus hence compromising the results achieved through Fleur-de-lis abdominoplasty. Pregnancy after FDL surgery can affect the aesthetic results of an abdominoplasty and require additional corrective procedures.

Skin Changes

The colour and texture of the skin commonly change due to hormonal shifts during pregnancy. Skin laxity also increases, causing the results of the FDL abdominoplasty to change. In most cases, hyperpigmentation of the skin goes down after pregnancy.

Scar Distortion

Incision scars may widen or become uneven during pregnancy due to stretching of the skin. Patients can have corrective surgeries after pregnancy to improve the appearance of the scars. This may involve scar revision surgeries to improve scar symmetry, texture, and overall visibility to restore the previous aesthetic results.

Increased Discomfort

Pregnancy after FDL surgery causes discomfort for the mother since the abdominal muscles are surgically tightened. Stretching of the abdominal skin may also cause sensitivity around the incision area. This discomfort may necessitate additional care and management strategies to alleviate symptoms and ensure the well-being of both the mother and the new baby. This may go ahead and cause baby blues after delivery for postpartum women.

Surgical Complications

Surgical complications like the formation of Hernia and seroma may arise during pregnancy because of the increased fluid retention. Other issues might include wound healing issues and infection. It is vital for patients to get prompt treatment to prevent further complications.

Mode Of Delivery

It is possible to have a Caesarean or vaginal birth after FDL abdominoplasty as long as there are no potential complications. C-section is preferred when the existing FDL surgical scars are at risk of tearing. Patients should consult healthcare providers on which mode of delivery suits them.

FAQs

Below are some commonly asked questions about pregnancy following Fleur-de-Lis abdominoplasty surgery.

How Should I Prepare for Pregnancy After FDL Abdominoplasty?

Preparing for pregnancy after FDL abdominoplasty requires a patient to get regular prenatal care, discuss delivery options with their surgeon, and ensure that the incision wound is healed.

Should I discuss my plans for pregnancy with my surgeon?

Yes. It is important to discuss your pregnancy plans with your surgeon to make informed decisions. The surgeon is required to tell you all the risks and considerations associated with pregnancy post-FDL pregnancy.

What If I Experience Complications During Pregnancy After FDL Abdominoplasty?

If there are any complications or physical changes in the abdomen during pregnancy, patients should contact their healthcare team for monitoring and assessment. Early detection of complications could prevent the development of issues like Hernia.

Will I Need Additional Procedures or Revisions After Pregnancy Post-Abdominoplasty?

Additional procedures post-pregnancy are determined by the patient’s desires and the impact of pregnancy on the abdominoplasty results. In most cases, patients do not require additional procedures.

Conclusion

Pregnancy post-FDL surgery comes with risks and considerations like skin changes and surgical complications. However, post-FDL pregnancy is generally not bad for both the mother and child if timed well. It is essential for the patients to book a consultation with their surgeon for tailored advise on when or if to get pregnant. Individualised consultation with Dr. Beldholm ensures a smooth and healthy pregnancy for the patient.

References

1. Alhumsi, T., AlKhudairy, Y., & Mortada, H. (2023). Pregnancy one month post abdominoplasty: a case report and review of literature. Case Reports in Plastic Surgery & Hand Surgery, 10(1). 
2. Dellon A. L. (1985). Fleur-de-lis abdominoplasty. Aesthetic plastic surgery, 9(1), 27–32. 
3. Wallach S. G. (2005). Abdominal contour surgery for the massive weight loss patient: the fleur-de-lis approach. Aesthetic surgery journal, 25(5), 454–465. 
4. Karunaratne, Y. G., Romeo, P. B., Willis, M., & Sanki, A. (2023). The Safety and Effects of Pregnancy after Abdominoplasty: A Systematic Review of the Literature. Aesthetic plastic surgery, 47(4), 1472–1479. 
5. Nahas F. X. (2002). Pregnancy after abdominoplasty. Aesthetic plastic surgery, 26(4), 284–286. 
6. Mitchell, R. T., & Rubin, J. P. (2014). The Fleur-De-Lis abdominoplasty. Clinics in plastic surgery, 41(4), 673–680.
7. Sadeghi, P., Duarte-Bateman, D., Ma, W., Khalaf, R., Fodor, R., Pieretti, G., Ciccarelli, F., Harandi, H., & Cuomo, R. (2022). Post-Bariatric Plastic Surgery: Abdominoplasty, the State of the Art in Body Contouring. Journal of clinical medicine, 11(15), 4315. 
8. Chen, E., Kao, C., & Ku, H. (2023). Fleur-de-lis Miniabdominoplasty Access in Radical Resection of a Large Abdominal Wall Desmoid Tumor. Plastic and Reconstructive Surgery Global Open, 11(10). 
9. Ali, A., & Essam, A. (2011). Abdominoplasty combined with Cesarean delivery: evaluation of the practice. Aesthetic plastic surgery, 35(1), 80–86. 
10. Averbuch Sagie, R., Wiser, I., Heller, L., Klein, D., & Hadad, E. (2022). Pregnancy Reverses Abdominoplasty Aesthetic Outcome: Myth or Misconception? A Cross-Sectional Study. Aesthetic surgery journal, 42(1), NP20–NP26.