Some doctors say a nip and tuck is necessary if you want to tighten your flabby belly after pregnancy. EVELINE GAN finds out if it’s true.
Some doctors say a nip and tuck is necessary if you want to tighten your flabby belly after pregnancy. EVELINE GAN finds out if it’s true.
Cheryl (not her real name) worked her guts out at the gym six days a week, went on a strict diet and paid close to $40,000 for non-surgical abdomen shaping treatments.
But, the 35-year-old mum of two still couldn’t get rid of her flabby belly – the result of two pregnancies.
Last year, Cheryl, who gained 30kg during her first pregnancy, went under the knife to get her pre-baby waistline back.
During the procedure, plastic surgeon Chua Jun Jie from Mount Elizabeth Hospital tightened the loose tummy muscles to create a narrower, shapely midriff and removed over 1kg of excess skin from her belly.
“My babies were huge, each weighing around 4.5kg at birth. The pregnancies stretched out my skin so much that after delivery, my saggy belly would fold over my C-section scar. I went into depression for a while because of it,” says Cheryl, whose kids are aged 10 and five.
As much as new mums love their babies, the same can’t be said about their post-baby pooches. Cue the desperate attempts at using exercise, diets, creams, massages and wraps to squash “mummy tummy”.
But plastic surgeons say these methods or other home remedies usually don’t work on loose skin. In Cheryl’s case, a nip and tuck is what’s needed.
“Unfortunately, there is very little that can be done to tighten loose skin other than by surgery. Other skin tightening techniques (see These might work, too) can only minimally tighten the skin,” says Professor Walter Tan, a specialist in plastic surgery and consultant at Raffles Skin and Aesthetics.
WHY SO SAGGY?
During pregnancy, your skin stretches to accommodate your growing baby. Skin sags when collagen fibres rupture as it overstretches, giving rise to stretch marks, Prof Tan explains.
“When this happens, the skin can no longer shrink back after delivery and mums will have much looser skin than before,” he says.
Most women will experience some degree of loose skin after pregnancy.
A few unlucky ones are left with an extensive amount of loose skin and even an overhanging “skin apron” above underwear, Dr Chua says.
Whether your skin bounces back or succumbs to gravity after pregnancy depends a lot on genes.
Those who gain a lot of weight during pregnancy, have large babies or multiples, tend to suffer more damage to their skin, adds Prof Tan.
While exercise and sensible eating may help you lose weight and excess belly fat, they won’t fix saggy skin, the doctors say.
The bad news doesn’t end there. Pregnancy usually stretches out and separates your six-pack abdominal muscles, too.
“No matter how many crunches you do, the solid six-pack will never form again. In some mums, the separation of the muscles is so bad that they have an abdominal hernia bulging outwards.
“One of my patients looked like she was still nine months pregnant several months after delivering her twin babies,” Dr Chua says. A hernia is a medical condition whereby an organ pushes through the muscles that are supposed to hold it in place.
EXERCISE IS KEY
But fitness trainers beg to differ. Pre- and post-natal fitness trainer Gladys Leong, who has three kids, says maintaining a toned flab-free body after pregnancy has “everything to do with diet and exercise”.
For example, taking too much sugary food can speed up ageing due to a process called glycation. This is when the sugar damages proteins in the blood, making the person more vulnerable to skin damage and premature wrinkles, she explains.
Certified personal trainer Kareen Lai, founder of Mums In Sync, says: “I won’t deny that surgery will give mums a taut tummy, but the results probably won’t last if they don’t change their lifestyles or maintain their weight.”
On the other hand, she says studies show that regular exercise can help improve the skin’s elasticity and pliability.
“How good your skin is also depends on how hydrated the soft tissues are, but keeping them well-hydrated isn’t just about drinking water. In reality, the more you move, the more hydrated, elastic and healthier your skin will be,” Kareen shares.
But this works only with long-term, consistent effort. Weight loss after having a baby should be gradual so the skin has time to “catch up”, she adds.
“We’re talking about a two- to three-year weight-loss time frame, not a two- to three-month type of magic. With this type of slow and steady weight loss, I’ve seen extremely overweight people acquire an ultra marathon-type of physique, minus the saggy skin,” says Kareen, who has two kids.
But that did not work for Cheryl.
“Everyone said it takes time for the skin to contract after pregnancy, so I waited. But even after I lost my pregnancy weight through exercise and dieting, and tried other non-invasive methods, my tummy remained terribly saggy,” says Cheryl, who is now confident enough to don a bikini and midriff-bearing tops after going under the knife.
“In hindsight, I shouldn’t have wasted so much time and money, and gone straight for a tummy tuck instead.”
While surgery might offer quick results, obstetrician and gynaecologist Christopher Ng of GynaeMD Women’s and Rejuvenation Clinic, says it should only be used when other non-invasive forms of treatments have failed, or in severe cases of loose skin.
“Surgery is invasive and has its risks, such as wound infections and death, so this should certainly not be the first line of treatment,” he says.
“It should also be offered once a woman has completed her family, as all the ‘hard work’ would be undone by the next pregnancy.”
Don’t wait till it’s too late
It is a myth that “lifting” creams can tighten loose skin after pregnancy, says Dr Chua Jun Jie from Mount Elizabeth Hospital.
“If you apply them after delivery, it is already too late. Creams can never penetrate the whole layer of skin and can only improve the superficial texture,” he shares.
What you should do to reduce skin damage is to frequently apply moisturiser to common stretch mark areas – tummy, breasts, thighs, buttocks and arms – as soon as you know you’re pregnant. The first few weeks of pregnancy are the most important.
NO PAIN, NO GAIN
Gladys Leong, 36, is a sports model competitor, personal trainer and co-owner of Hercules Fitness, a personal training studio. She has three kids – Ian, Zac and Wyn – aged 12, seven and four.
With her youthful looks and washboard abs, Gladys Leong is often mistaken for her three kids’ elder sister.
“Or an underage mum. But I take it as a compliment,” the 2016 NABBA-WFF Sports Model Pro winner quips.
NABBA-WFF, which stands for National Amateur Bodybuilders Association-World Fitness Federation, is a physique competition.
Weighing 40kg and boasting a body fat percentage of just 6 to 8 per cent whenever she preps for competitions, Gladys picked up bodybuilding after having her third child Wyn, now aged four. The average body fat percentage for women is around 20 per cent, she shares.
“Initially, I tried bodybuilding out of curiosity, but it has since become my passion. I hope to change the mindset that bodybuilding always bulks up the body. That’s not true, as a lot depends on controlling your diet,” says the pint-sized dynamo, who stands at 1.56m.
A trim and strong physique did not come easily to Gladys, who used to struggle with weight issues in her late teens and early 20s. Back then, her body mass index (BMI) of about 24 was within the unhealthy range. She later lost the excess kilos through exercise.
Today, Gladys, who gained about 20kg with each pregnancy, practises what she preaches when she tells other mums “no pain, no gain”.
She believes the key to losing the post-baby flab is through eating right and exercise, a powerful combination that can also help tired, frazzled new mums boost their energy levels.
“Like other mums, I struggled with a flabby tummy after my three pregnancies, but I pushed myself to work out at least five times a week after birth. I would exercise for about an hour at night after the kids go to bed.
“Sure, that meant a little less sleep for me but I was determined never to go back to being overweight again. To make up for less sleep at night, I would take cat naps in the day,” she says, adding that she has more time to exercise now that her kids are older and more independent.
Gladys went back to her pre- pregnancy size within two months of childbirth through body weight exercises like squats, crunches and leg lifts – the latter two workouts being particularly effective in firming up loose skin and tummy flab.
She also did light weight training with a pair of 2kg dumbbells, but says other mums should first get their doctors’ approval before following suit.
Mums looking to firm up their post-pregnancy tummy, core and glutes should try planking, she suggests.
This simple and safe exercise – there are lots of videos on Youtube showing you how – can be done at home. Start off by planking for 20 seconds, gradually increasing each session by 20 seconds every day until you break your own record, she suggests.
EATING WELL
While Gladys is ultra disciplined about exercise, her idea of eating well is more lax. After childbirth, she ate typical Chinese confinement dishes, but omitted anything too oily or fatty such as pork trotters.
She still dines out. The trick to maintaining weight while dining at hawker centres is to choose your food wisely, she says.
“At the food court, I’ll opt for dishes without added oil like sliced fish bee hoon soup. I don’t touch the soup to avoid taking too much sodium, which can cause water retention. I usually only prep my own meals when a competition is coming up – that’s when I boil or steam everything without salt or condiments,” she shares.
To encourage mums to keep fit and healthy, Gladys started a Facebook group, No Flab Mommas (http://www.fb.com/NFMommas), where like-minded individuals can share their tips on body shaping, toning and healthy eating.
She hopes to steer mums away from the misconception that pregnancy will inevitably cause their bodies to go out of shape.
“It is still possible to look and feel good after having kids,” she says.
FROM FLAB TO FAB
Kareen Lai, 34, is a certified fitness trainer and founder of Mums in Sync, which runs fitness and nutrition programmes for mums. Her twins, Kiran and Aasha, are six years old.
Looking at Kareen Lai’s trim figure now, it is hard to imagine that she once struggled with weight issues after gaining a whopping 30kg during her pregnancy about seven years ago.
Pregnancy complications in the form of early contractions and preeclampsia had made it hard for her to keep active while carrying the twins. The latter is a potentially life-threatening pregnancy condition marked by high blood pressure.
By the time Kiran and Aasha were born at 32 weeks, Kareen had gone from a svelte 55kg to 85kg. At birth, the twins barely weighed 3kg together.
The excess weight left her with a flabby tummy, which refused to budge even after she underwent postnatal massages and hit the gym.
“I even paid over $1,000 for 10 slimming treatments which required me to run on this special elliptical machine with infrared rays. It was supposed to increase my metabolism. I didn’t see results at all after all that money and time spent,” she shares.
Upset that she continued to “look and feel five months’ pregnant” months after giving birth, Kareen turned to a scientifically backed online weight loss programme by an overseas fitness coach.
“Back then, I was a climbing coach and physical-education teacher at a junior college, so I felt like I had to step up to show my students that motherhood isn’t frumpy,” says Kareen.
Inspired by her own transformation, she took up exercise and sports nutrition courses by the American Council on Exercise and National Academy of Sports Medicine, both of which offer globally recognised fitness accreditations.
Today, Kareen is a certified fitness coach who runs fitness and nutrition programmes for mums struggling with weight issues.
Following her coach’s structured meal and exercise plan, the determined mum worked out almost every day and packed healthy meals to work; this allowed her to consistently eat clean.
Even when dining out with colleagues and friends, she would bring along her packed meals. So while they slurped up greasy bak chor mee (minced pork noodles) at the food court, for instance, Kareen would be tucking into wholesome stir-fried quinoa with vegetables and some grilled chicken or eggs.
While her strict weight loss regimen might sound like an uphill task, she says everything boils down to motivation and good planning.
“You need to be disciplined about planning your meals in advance. You can’t go through your day unplanned if you want to lose weight, because you’ll just grab anything to eat,” she says. “If you’re motivated to become healthier, you’ll find ways to make things work.”
HELP AT HOME
That said, Kareen admits that she is also fortunate to have a hands-on husband and mum, who help out with the kids. He tucks them into bed at night so she has time to prep her healthy meals for the next day.
Another lifestyle adjustment she made was to get more sleep and rest; the lack of shut-eye makes it harder for mums to lose fat, she explains.
Ideally, everyone should get at least seven hours of sleep each day, but since that is not possible for new mums, regular naps and rest periods would be the next best alternative.
“I was very stressed during the first few months after my babies were born, which was probably why I found it hard to lose my belly. Tummy fat is linked to high cortisol (a stress hormone). The stress also affected my breast-milk production,” says Kareen, who stopped nursing when her twins were five months old.
Now weighing 56kg, the glowing 1.65m-tall mum says “every little bit counts” when it comes to getting a fit post-baby body. She encourages inactive mums to start with small steps.
“Even if you start off with just three minutes of exercise every day, you can gradually increase it to five, 10 and then 20 minutes,” she says.
Ultimately, having a fit and toned body is a long-term journey, not a quick fix; sticking to healthy habits in a sustainable way is essential.
“It’s what you see in the mirror, not the weighing scale, that matters. At my lowest weight while prepping for a fitness competition, I was only 53kg,” she says.
“But maintaining that weight is not sustainable for me because it means being very strict with my diet. I still want to be able to enjoy good bakes every now and then.”
