When the knives are out, what are your options?

On and off went the third outfit. It’s not like I was going anywhere, just trying to find something that looked like I was not on my way to check into an Overeaters Anonymous meeting. I stood, deliberating, in a pair of control top pantyhose. They were not properly pulled up and were cutting off the circulation to my lower hip. The top half of my hip was hanging over the waistband in a lumpy roll. I turned to the bed and saw that my husband was looking at me with a quizzical expression. He had put his book down and had clearly been watching me for some time. I would have been comfortable with the expression if I were selecting a paint colour for the garden wall. But I was naked. Worse, I was wearing foundation undergarment that should only be revealed on pain of death.
“Are your boobs smaller?” he asked.
Deny.
Put on surprised smile.
“Are they?” I asked. “I hadn’t noticed.” That did not do the trick.
“It’s just like they are less … soft. Like they are the same, yet not the same.”
 
IT WAS THEN THAT HE OFFERED ME A BOOB JOB IF I THOUGHT IT WOULD MAKE ME FEEL BETTER. He had watched my tortuous coming to terms with my new body.

I had always joked about having no objection to buying youth and pert breasts, but I was now being offered a very real choice. Somehow, I expected the choice to come when I was around fifty, not twenty-nine.  Who can blame a girl for considering going under the knife? These are the moments where that slush fund for a rainy day starts to show its benefits. Who says droopy boobs aren’t a rainy day?
“It was a holiday for the two of us in the East – a three week luxury trip, we had been saving for.  I had all but forgotten the plans until Neville said he wanted to checck dates with me to buy the tickets. A month later, I had a tummy tuck and breast augmentation and lift with the money instead,” says Marcia. “Now, that's what I call a real holiday.”

Perhaps we think of our fannies and pert boobs are withus for the long haul, with no service date. But this is not the case. While penoplasty has had its day in createing an awareness that there are surgical procedure out there for men and their not so danggly bits, ther eis little awareness that hlp is at thand for women who simply cannot, or do not want to, come to terms with a new body.
And frankly, it is cheaper to get that fat sucked out than to replace a wardrobe of couture. Or that's the party-girl line, and we are sticking to it.
If there is a trend that defines our postpartum physique, it is a distinct lack of tone. Everything is slack, from our previously taut tums to our vaginas.
There cannot be a new mother who has not caught sight of her tail and thought, “Whose rump is that?” And if your baby came out the sunroof, don’t think you are any better off. Sure your vagina may not look like a giant, unstuffed cannelloni tube, but you are not going to escape all the “joys” of motherhood.
 
Let’s refresh our memories:
 
·       Flaccid belly
·       No waist
·       Thighs that fall in folds over your knees
·       Slack fanny
·       Droopy boobs
 
Childbirth is a trauma to your entire body. It is massive, invasive… and totally natural. But make no mistake, things can and frequently do, go wrong. More commonly, things don’t go wrong, they just don’t shrink back into place. Thank God we live in the twenty-first century where we can put them right.
 
Let’s take a look at what you can do:
 
Vein removal
 
Spider veins : These are known by the white coats as telangiectasias or sunburst varicosities, and are those small, thin veins that lie close to the surface of your skin. They mostly clear within three months of a birth but can be permanent.  Varicose veins are thicker, larger and darker, and they bulge. If you think you might want vein removal surgery, you should wait until you’ve had all the children you want because, unfortunately, varicose veins tend to worsen with each pregnancy and with age.
 
The Op
 
Sclerotherapy : In this rather simple but costly procedure, veins are injected with a solution that causes them to collapse and fade from view. The injection causes the walls of the vein to fuse over a period of a couple of weeks. The vein then shrivels up and is absorbed back into the body. Because surface veins carry relatively little blood, the body easily reroutes flow to deeper veins.
A typical sclerotherapy session can be done during your lunch hour and you will get between five and forty injections in a session – one for 2.5 cm of vein. Depending on the number and size of your enlarged veins, you may require several sessions. Afterwards, you’ll most likely need to wear compression stockings from a few hours to a few weeks, to keep the  shrunken veins from refilling.
 
Mini-stripping (ambulatory phletectomy) : The doctor will make tiny incisions along the length of an enlarged vein.  She then uses a hook to actually scoop out tiny sections of the vein.
 
Laser or needle : Laser surgery is also available and this works in a similar way. The heat generated by the laser causes the blood vessel to disintegrate. It’s effective, but sclerotherapy is still more popular. Working in a similar way is a process similar to electrolysis that involves zapping veins with high frequency waves that pass down a fine needle and into your vein.
 
The Catch?
 
It’s not cheap, but it can be done with a local anaesthetic, on an outpatient basis. The procedure carries the usual risks of undergoing surgery, including a small possibility of scarring and infection.  These fixes aren’t permanent. If you got varicose veins once, you may get them again. The surgery has its own dangers, including infection and scarring at the injection sites, but they are relatively rare. Some women have reactions to the solution. Expect  some  temporary  bruising.  A  lot  of  women  find  they remain with pigmentation marks in the area for up to two years.
 
Slimming clinics
 
The costs of salon work are a fraction of what you would spend on surgery, but this is still not an alluring option if you are on a tight budget. Your post-birth bulk can be targeted on two fronts.
 
1.     Break down fat and cellulite with a G5 slimming machine. This hand-held device vibrates over your fat like a  jackhammer. You know what a jackhammer does to tar? Well, this will purportedly do the same to your fat. It then leaves it up to your lymph system to flush out the broken down fat. It will most certainly get the circulation going in those areas; not a bad thing.
2.     Tone your slack stomach muscles with passive exercise toning pads. These go under various brand names but essentially send electrical impulses to your muscles, causing them to contract and spasm. Feels mildly strange but nothing too alarming. Salons claim it’s as effective as three hours in the gym.
 
The Catch?
 
This will only work if you are prepared to work with the programme. You cannot strap yourself to a vibrating machine while slurping a milkshake. Stick to a calorie controlled diet and an exercise programme and you will see results.  Otherwise, don’t waste your money.
 
Breast lifting (mastopexy)
 
This is a lift. It will give you higher, not larger, breasts. If you want both, you need to combine a breast lift with implants. If, on the other hand, you have large breasts and would like them lifted and reduced, this is possible; skin or tissue can be removed at the same time as the lift.
Wait until you have had all your children before you opt for breast surgery as round two may set you back to square one. A mastopexy can be performed under local or general anaesthetic. It can be performed as an outpatient procedure and you will be home within a few hours of surgery. It’s a lot less painful than implants even though the cuts are larger.
 
The Op
 
The surgeon will make an anchor shaped incision, going along the underside of your breast and up to your nipple. The skin will then be gathered, excess skin cut off, and the site will be stitched. Your nipple and aureole will be reattached higher on your breast.
 
The Catch?
 
Surgery carries risk. Your breasts will be bruised and swollen, but the pain is not severe. Some women may have numbness in the aureole or a change in sensitivity in the entire area, particularly the nipple. Scarring will depend on the surgeon and your own scarring capacity, but scars can remain red, raised and unsightly. You could also be left with unevenly positioned nipples.  You should also keep in mind that a breast lift doesn’t keep you firm forever. Skin does age and stretch.
 
TIP : For any work on your breasts, it is vital that you find a surgeon who comes recommended. Plastic surgery is part science and part art and not all surgeons are created equal, Dr Jekyll.
 
Breast enlargement (augmentation)
 
Most women will have smaller breasts after pregnancy, whether they breastfeed or not. During pregnancy, the milk glands in your breasts swell and actually replace the fatty tissue that gave your breasts a full, soft look. When you stop breastfeeding, the glands shrink, leaving you with less bulk than before. This will cause the breasts to look less full or sag.
A breast enlargement is not a lift.  If you want your breasts higher on your chest, you will need to combine an enlargement with a lift. Although, bear in  mind, the implants will give them a firmer shape in any case.
 
The Op
 
This is done under either local or general anaesthetic and you can check out the same day, though an overnight stay is recommended. A small incision is made in each breast and a cavity created inside your breast. The small incisions are virtually undetectable and are usually made under each breast around the nipples or in the armpits. Implants may be inserted just under the gland of the breast or beneath the muscle tissue. Stitches are removed after approximately a week.
All breast implants now in use consist of a silicone shell, which is either factory filled with silicone gel or is filled during surgery with saline. Other fill materials are being investigated experimentally. Despite ongoing reports in the media, the Association of Plastic and Reconstructive Surgeons maintains there has never been a systemic illness definitively  attributed to silicone implants. Mothers with implants can breastfeed with no risk to the baby.  The implant is placed either behind the major pectoral muscle that runs down your chest, or in front of it. The problem with placing it in front of the muscle is that your body’s healing mechanisms may be too powerful and scar tissue can surround the implant, making the breast appear as if it has a hard lump.
 
The Catch?
 
·       You need a week off work to allow for adequate recovery.
·       The pain – breathtaking. It far outstrips the pain of a breast lift.
·       A small percentage of women develop an infection around an implant. This may occur at any time but is most often seen within a week after surgery. If antibiotics are not effective, the implant may need to be removed for several months until the infection clears. A new implant can then be inserted.
·       Concerns regarding the long-term safety of silicone remain.
 
Tummy tuck/stomach tightening  (abdominoplasty or lipectomy)
 
A tummy tuck is the big sister of liposuction and entails actually removing a bulk of sagging skin and fat. If you are at your ideal weight and your stomach area is still a loose, flabby mass of skin, stretchmarks and scarring, you can start looking at abdominoplasty. These operations are usually excruciatingly painful but very successful.
 
The Op
 
The surgeon will start with a cut that goes from hip to hip and a separate cut to free your navel from the skin.  Next, your skin is lifted off the abdomen, starting just above the groin and going up to near the rib cage, to expose the abdominal muscles. These will be pulled closer together and stitched into position. Then skin is then pulled down and  inwards, the excess skin is cut off and the remaining skin sewn back into place. A new super-neat bellybutton will be created out of skin.
If you have only a small amount of excess skin and it is limited to below your bellybutton, you may be a candidate for a mini lipectomy (a less extensive procedure, often done under local anaesthetic), possibly combined with liposuction.  Here, the operation will take place on a smaller scale and only below your navel. Full abdominoplasty will take up to five hours. A temporary tube may be inserted to drain excess fluid from the site.
 
The Catch?
 
Recovery is slow. This is a major op. You will stay in hospital for at least a day, or for up to a week, depending on the  amount of skin and fat removed.   Anticipate booking four weeks off work. After ten days, you will be able to stand fully upright. Scarring will take up to six months to start to reduce.
The scar is large and permanent. It will run from hip to hip but usually under your bikini line. Severe scarring can occur  and is usually due to genetic factors.  There will be a degree of numbness in the skin, but this should be temporary. Infection and clotting are risks, but they are rare and can be treated with drainage and antibiotics. Early movement will minimise the risk of clotting.
 
​