Pregnancy leads to changes in a woman’s body. After pregnancy many of the changes can be reversed either totally or partially. However, in some women the changes persist long after the post partum period despite good intentions and best efforts on their part.
Here is an example.
I had a neighbor years ago who had two children and after her pregnancies she noticed a pouch in her abdomen. She was very determined to improve and possibly resolve this problem. She hired a personal trainer and together they worked diligently for nine months. During that period of time she did 250 sit-ups in the morning and 250 sit-ups in the evening. The result of that was her muscles were strong but she still had the pouch in her abdomen.
What determines if the changes that occur will persist after post partum period?The key here is what I call the shriveled balloon effect. It is basically the extent to which the skin and tissues have been stretched during the pregnancy that determines the tissues’ ability to snap back into their pre-pregnant condition.
For example: if you take a normal balloon and put a little puff of air in it and let the air out of the balloon, it will return essentially to its normal shape. If you take the same balloon and put air in it and keep expanding the balloon until it is about ready to pop and let the air out, the balloon is thinned and shriveled and it is not the same as what it was prior to blowing it up. Very similar thing happens in pregnancy to the skin of the breasts and abdomen.
For example: Let’s consider a woman that is about 5’ 2” and about 110 lbs. and gains 65 lbs in pregnancy. Often times the stretch that occurred during pregnancy are such that the body isn’t able to snap back into the shape it was before pregnancy. On the other hand, if the same 5’2”/110 lbs. woman gains only 25 lbs., the stretch is much less likely to persist and it is more likely she will have a relatively normal shape after the pregnancy.
What is the definition of the Post Baby Body Syndrome?It is the changes that occur in a woman’s body after the postpartum period that persist despite exercise, diet, and nutrient treatment. These changes are often permanent. I discovered the syndrome after the following event occurred in the life of one of my patients.
We will call her Mary, though this is not her real name. She was scheduled for a Tummy Tuck. She is 43 years old, normal weight and great health. She runs several miles three times a week and does yoga twice a week. She has two teenage sons, and since their births she has had a persistent bulge and loose skin in the abdomen. She wanted to do something about it and finally decided to have surgery.
In the process of getting ready for her surgery she went to her Primary Care Physician to get routine blood work done. When her doctor saw her, Mary was told that she needed to lose weight and there would be no value of having a Tummy Tuck. Mary was very angry with her doctor, as it was obvious to her he did not fully understand her situation. Besides which she felt that the doctor was preaching to her. Much later, Mary shared with me the story of what had happened and how she felt that day.
What became obvious to me is that many of my patients who come in believe they are failures, because the effort they expended to get rid of the pouch in their abdomen, for example, were to no avail. I was shocked to discover that a medical professional was not even aware there can be persistent body changes in a woman after pregnancy and sometimes, no matter what they do in terms of exercise, diet or therapy… those changes persist.
What are the criteria for Post- Baby- Body Syndrome?
Often the skin is stretched and loose, and does not have the ability to snap back normally like skin with good tone does.
The fascia ( tissue holding the muscles) - particularly the muscles of the abdomen -has been stretched. No amount of exercise or sit-ups will help this skin to return to normal.
The pelvic area is often widened, looser and may have a slight tilt.
There are breast volume changes. Sometimes the breasts are larger but more often than not, there has been a shrinking resulting in a loss of breast volume. In addition, there can be a difference from one side to the other, with the breast being lopsided as a result.
Often times weight has been added to the hips and outer thighs. That, coupled with the widening of the pelvis, leads to a more matronly appearance. A matronly widening, if you would.
There can be changes in the floor of the pelvis resulting in dysfunction of urination and bladder control.
There are often some vaginal changes that occur as well.
In summary, women after pregnancy can generally be divided into two main groups. One group can return their body to normal or near normal with exercise and proper diet.
The other group of women find that despite all efforts - exercise, diet, etc. - the changes that have occurred to their body are permanent, persistent and do not respond to conservative modalities of treatment.

Robert J. Kenevan, M.D
Medical Director
Avalon Clinic for Cosmetic Surgery