AskID: Looser skin on lower abdomen

We asked Prof Caitriona Ryan:
‘The “C-section pouch” is the bane of so many women’s bodies post-pregnancy, and can make women much more self-conscious about their bodies. It can often be significant enough to affect clothing choices.

The pouch comes in different shapes and sizes depending on contributing factors, which are important to assess when determining the best treatment plan. For most women the pouch is caused by a combination of 1. skin laxity due to stretching and tension on the skin during pregnancy; 2. poor muscle tone after pulling apart of muscle fibres of the rectus abdominus (divarication of the recti) during pregnancy and cutting through the muscles of the lower abdomen; and 3. deposition of abdominal subcutaneous fat in this area.

The most important first step is making healthy lifestyle choices, primarily through a healthy diet and exercises to strengthen the core, but for those who have optimised their overall body weight, both several non-invasive procedures and surgical procedures can target and eliminate this stubborn pouch.

Abdominoplasty, or” tummy tuck” is an invasive surgical procedure which removes excess fat and loose skin from the lower abdomen with tightening of the lower abdominal muscles. The procedure takes approximately 4 hours. The scar is a little longer than a C-section scar but typically concealed below the bikini line. Another small scar is typically left around the umbilicus as this is relocated as part of the procedure. Lifting and driving is not permitted for six weeks after the procedure. Patient are typically very satisfied with the procedure results.

Many women, however, wish to avoid invasive surgery and several excellent non-invasive procedures can produce excellent results.

For those who are primarily bothered by the fat fold which overhangs their scar, Cryolipolysis (fat-freezing) with Zlipo is an excellent option to target this persistent diet- and exercise-resistant fatty deposit. The highly innovative ZLipo system makes it possible to target fat depots and reduce them permanently and non-invasively.

This method cools fat deposits over a longer period of time to a controlled and safe temperature range. Unlike other forms of cryolipolysis (fat freezing), ZLipo begins with a pulsed vacuum suctioning to further break down the fat cells before the freezing begins and increases the positive effect on lymphatic drainage and metabolism. This is followed by ZWave treatment which uses high energy radial shockwaves to tighten the overlying skin and reduce stretch marks. The complete breakdown and removal of fat cells through the lymphatic system takes about 10–12 weeks. Patients usually require only one treatment per area. The treatment is virtually pain-free with no downtime, and results last a lifetime.
For those with both poor muscle tone and stubborn fat in this area, Emsculpt Neo is the ultimate body-shaping procedure, which combines high-intensity electromagnetic stimulation for muscle building with radiofrequency for fat elimination in a 30 minute session. The end result is more fat reduction and muscle growth than any single gold standard product in the shortest possible time. Treatment time with Emsculpt Neo is 20-30 minute treatment with 4 sessions scheduled 2-7 days apart. The procedure feels like an intensive workout with intense muscle contractions together with a heating sensation in the treated area which is comparable to hot stone massage. It is non-invasive and requires no recovery time or any pre/post treatment preparation. Patients observe results immediately after their first treatment. Considerable improvements are usually reported two to four weeks after the last session and continue to improve for several weeks following treatments.