The Post Baby Pooch

Genetics and the dramatic hormonal changes of pregnancy can leave a woman with a localized collection of fat in the mid to lower abdomen that is hard to get rid of, even after getting back down to the pre-pregnancy weight– the Post-baby Pooch. My patients tell me that this fatty pooch can be a cause for embarrassment (“Are you expecting again?”) or lack of self-confidence, especially when wearing the tighter fitting clothes, like the slinky black dress, that they enjoyed before the pregnancy.

Even normal weight individuals may have a curiously round volleyball-shaped fat deposit that does not respond to proper diet and exercise. Abdominal exercises may tone the underlying rectus abdominus (“six-pack”) muscles, but this will only flatten out the dome a bit.

By the way, contrary to popular belief, any type of “spot reduction” exercise can only tone the underlying muscles, but does virtually nothing for the overlying fat. Fatty stores reduce in size, whether they be around the waist or the big toe, when you burn more calories than what you put in your mouth. The body is then forced to go to what I call the “Calorie Store,” your adipose (fat) tissue, to get fuel there. Hormones and your genetics play a role in which “shelves” are depleted first and which “shelves” — like the Post-baby Pooch — are hard to reach and remain well stocked.

Many treatments are designed to specifically target localized fat. Abdominoplasty, commonly referred to as “tummy-tuck,” involves cutting away a new moon-shaped wedge of skin and fat from the lower abdomen. The resulting scar may extend from hip bone to hip bone, but it can usually be hidden below the panty line. Recovery can be painful, and the is strict limitation of certain physical activity, including lifting and exercise, for several weeks.

There are noninvasive laser and alternate energy devices that use specific laser wavelengths, infrared, or radiofrequency to shrink the size of the fat cells or to make the fatty tissue appear more compact by tightening the overlying skin. Some common ones are Thermage, Accent, VelaSmooth and VelaShape, Lipo-Ex, and Zerona. Usually multiple treatments are required over several weeks or months to see appreciable results, so you must have patience and realistic expectations.

Other noninvasive treatments include Mesotherapy for fat loss or the more simplified Lipodissolve injections that contain ingredients designed to make the fat cells in the injected area release some of the fat that they contain. Once outside the cells, the released fat is cleared from the area by the body’s lymphatic system. As with the noninvasive devices, multiple treatments (and patience) are usually required to see appreciable results.

Most folks nowadays want immediate results, if possible. Advanced Smartlipo laser and Vaser procedures can eliminate the “Post baby Pooch” in about one hour, with no general anesthesia, no large scar, no prolonged recovery, and no severe pain requiring narcotic pain killers. Most patients return to work in 3-4 days and to moderate exercise in about one week. In skilled hands, the results are also smoother and tighter than with traditional liposuction, due to additional skin tightening effects. This technology is also very useful to revise areas of previous liposuction, tummy- tuck (“dog-ears”), breast reduction (along the sides), or other procedures where the fat has healed irregularly or unevenly.

If you have any of these issues, a personal consultation and examination is the only way to determine which options are best for you.

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