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What pregnancy changes
Pregnancy stretches the abdominal skin, widens the linea alba between the two rectus muscles and changes the breast. A mommy makeover treats each layer: skin and fat are removed, the muscle layer is tightened with sutures, and the breast is lifted, filled or reduced.
Outside to inside
Stretch marks (striae gravidarum) were found in 260 of 420 women (62%) after delivery in one study, with greater weight gain in pregnancy as a risk factor. They are permanent. A tummy tuck removes or improves stretch marks on the skin it cuts away and cannot correct the rest.[1][2]
In 150 women who had never been pregnant, the linea alba was normal up to 15 mm wide at the xiphoid, 22 mm above the navel and 16 mm below it. In 300 first-time mothers, a separation of 2 fingerbreadths or more was present in 60.0% at 6 weeks and 32.6% at 12 months after birth. In 117 women, the largest widening came between the first and second pregnancy, 1.9 cm on average.[1][2][3]
Nahas classified the muscle layer in four types. Type A is rectus diastasis from pregnancy, treated by plication of the anterior rectus sheath. Types B to D add laxity of the lower and side wall, high rectus insertion or a poor waistline, treated by plication of the external oblique aponeurosis or muscle advancement.[1]
In pregnancy the milk ducts expand into the breast fat, the breast enlarges and the areola darkens, and after weaning the gland involutes. In 132 women seeking breast surgery, 85% who had been pregnant reported a worse breast shape. Age, number of pregnancies, larger bra cup, higher BMI, weight loss over 50 lbs and smoking predicted sagging; breastfeeding did not.[1][2][3]