| PREGNANCY AND AESTHETICS | PEER-REVIEW
Patrick Treacy explains how the changes experienced during and after pregnancy can lead women to seek aesthetic procedures for a number of issues, including sagging skin, stretch marks, and excess fat
ABSTRACT
Pregnancy causes many changes in a woman’s body. The growing foetus causes mechanical changes by stretching skin, muscle, and fascia. The amount of physiological change during pregnancy varies among women but often persist long after the post-partum period despite the best efforts of the
skin, muscle, and fascia and demanding an increased calorific supply2
P . during pregnancy varies among women3
. The amount of extra weight gained . The National
Health Service recommends that the overall weight gain during the 9 month period for women who start pregnancy with normal weight should be in the region 10 to 12 kg (22–26 lbs) but as many British females are already over weight these figures may be downsized. Physicians are aware, insufficient weight gain can compromise the health of the foetus during pregnancy and excessive weight gain can pose risks to the woman and the baby. For women who have gained weight between pregnancies, even a relatively small gain of 1–2 body mass index (BMI) units can increase the risk of high blood pressure or diabetes during their next pregnancy and may also increase the chance of giving birth to a large baby. New advice has just been published by the National Institute for Health and Clinical Excellence (NICE) as part of its public health programme4
It states that women who are obese (with a BMI over
30) when they become pregnant face an increased risk of complications such as diabetes, miscarriage, pre- eclampsia, blood clots, and death. Obese women are also more likely to have an induced or longer labour, post-delivery bleeding, and slower wound healing after
KEYWORDS Pregnancy, fat, cellulite, stretch marks
patient regarding exercise and diet. Many women find it difficult to deal with these major body changes and this article theorises why humanoid females are almost unique amongst species in accumulating fat in the bitrocanterea (saddlebag or culotte) area and lower abdomen midriff, while males seem
REGNANCY LEADS TO MANY CHANGES in a woman’s body, mainly through the interaction of steroid hormones, lactogen, and cortisol on the underlying tissues and structures1
. The growing foetus itself causes mechanical change by stretching
more prone to develop visceral fat around their organs? It also notes how during
pregnancy human skin
often stretches out of shape and loses the ability to spring back into shape forming sagging breasts and stretch marks in the period. Lastly it looks at other changes such as pigmentation
and varicose veins and what patients should do to get the best aesthetic result and get their bodies back to a pre-pregnancy state. Many of the examples and treatments mentioned are based on the personal preference and experience of the author
delivery. They also tend to be less mobile, which can result in a need for more pain-relieving drugs during labour. These can be difficult to administer in obese women, resulting in a greater need for general anaesthesia with its associated risks4
. So why do women have such a hard time dealing
with this major body change, which often persists long after the post-partum period despite their best efforts regarding exercise and diet? Why do females develop layers of subcutaneous fat around their midriff, their buttocks, and inner thighs while males seem more prone to develop visceral fat around their organs? Why do pelvic bone widening changes occur in humans often causing major distress resulting in long term urinary and bladder dysfunction? Why does the skin stretch out of shape and lose the ability to spring back into shape?
Adipose tissue For many years, there was little interest in the biochemistry or physiology of adipose tissue. It is now well recognized that adipocytes play an important dynamic role in metabolic regulation. They are able to sense metabolic states via their ability to perceive a large number of nervous and hormonal signals. More recent insights show that adipocyte secretion itself can have a major metabolic impact5
. The breakdown of cellular fat
stores fuels energy production and multiple anabolic processes. Albert et al, demonstrated that the lack of hormone-sensitive lipase, a member of the enzyme trio that catabolizes fat, has pronounced effects on lipid metabolism, glucose homeostasis, and cell signaling in
prime-journal.com | March 2015 ❚ 55
PREGNANCY AND AESTHETICS
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