Last month, we explored breast rejuvenation options available to women after giving birth. But the postpartum body can present a range of challenges. Another concern for many women is the “baby fat” that seems so hard to lose.

    “Fat deposits and weight gain are a normal part of pregnancy and are necessary for the healthy development of a normal birth-weight newborn,” says Michele Koo, MD, of the Aesthetic Surgery Institute. “Fat accumulates during pregnancy in the same areas that plague most women even when not pregnant: the abdomen, hips, waist, and inner and outer thighs.”

    Diet and exercise are important throughout life, but “during the postpartum period, the woman may be recovering and exhausted and, therefore, not devoting time and energy to healthier eating and exercising,” Koo notes. “The weight then seems to be extremely ‘stubborn’ and resistant to exercise, but in fact the fat is very readily reduced with diligent adherence to exercise and healthier eating.”

    All experts interviewed for this article agree that women need to give themselves at least six months of healthy habits to lose weight and tone muscles after giving birth. However, some fat deposits may remain regardless of how many sit-ups you do or how many cookies you pass up.

        “It is my opinion that if after one to two years postpartum a woman has not lost her pregnancy weight, she will not be able to do it,” Koo says. “Even if she achieves her pre-pregnancy weight, she will not look the same unless all of the skin has tightened, which becomes less and less likely with each subsequent pregnancy.”

    Liposuction is one option for dealing with the pockets of fatty tissue that seem impervious to diet and exercise. “It can help women feel better in their clothing and get rid of uncomfortable bulges,” says Judith Gurley, MD, a plastic surgeon who practices in Chesterfield.

    For women who’ve had a cesarean section, liposuction can serve the secondary purpose of making the C-section scar less noticeable, she adds. “Some woman have a C-section scar that is indented, irregular or crooked. When doing liposuction on these patients, I’m very careful to suction around the scar to make it as flat as possible. In some cases, I can revise  the C-section scar to make it flatter, smoother and not as noticeable. In fact, I may use the scar as a point through which to insert the liposuction cannula.” The cannula is the tube used to suction the fat during the procedure.

    Gurley notes that there are several ways to perform liposuction, and patients should discuss the pros and cons of the various procedures with their plastic surgeon. Liposuction recovery is fairly rapid, and patients typically resume all physical activities within a couple of weeks.

    Women who have significant stretch marks and skin laxity may consider abdominoplasty (tummy tuck) along with liposuction. However, abdominoplasty is much more involved than liposuction alone and should be done only after a woman has finished childbearing, says Paul Rottler, MD, a plastic surgeon who practices in Kirkwood.

    “Patients need to have realistic expectations about what can be achieved through liposuction alone,” Rottler says. “If stretched, lax skin is a problem, liposuction will not correct it. The skin may contract slightly after liposuction, but many women do not have sufficiently elastic skin. Therefore, it’s important to be realistic and conservative in one’s expectations.”

    He adds that liposuction alone also may not produce the same results in the abdomen that can be achieved when treating the hips and thighs. “The abdominal compression garment worn after liposuction, which helps the tissues retract around the spaces created when the fat is removed, may crease and roll when the patient is seated, causing unsightly bulges in the treated area. “I discuss all these issues with my patients and make sure they understand exactly what can be achieved and what cannot,” he says. “We all want the most positive outcomes possible.”