What Are Stretch Marks?

As a Board Certified Plastic Surgeon in New York City, I am no stranger to patients looking to remove stretch marks. They are those wide, scary marks that start out pink and can turn red or brown depending on your skin type. Eventually they turn silvery white. What might surprise you is that more and more of them are men.

Men get stretch marks for different reasons than women. The most common causes are puberty, rapid weight gain, steroid use, and overaggressive weight lifting especially at younger ages. Women get them from pregnancy, hormonal changes, and weight swings.

Stretch marks are a tear in the deeper layers of the skin caused by a stretching force from the inside out. This leaves the surface of your skin intact, but it is empty underneath making it appear like a run in a stocking. Most often they appear on the stomach, shoulders, and hips and thighs.

How do you erase a stretch mark? That is the trillion dollar question. In short, you can not erase a stretch mark, but you can make it look much better. There is no laser, cream, or peel that will magically eliminate these scars as of yet.

The only way to remove a stretch mark 100% is to remove the skin it is on. In women, a tummy tuck can often accomplish this. In men, if it is the stomach that has the striae after weight loss, this is possible. Yes, I have done tummy tucks on many men. But what about shoulders and legs?

We treat each stretch mark differently. We use some creams to help fade the color, and have had good success with Silkpeel, dermabrasion, and laser in the right patients. Men like it, because it does not involve surgery or time off from work.

So don’t feel alone, ladies. Some men also feel your pain.


Timing of Plastic Surgery After Pregnancy

One of the major reasons that patients come to Yager Esthetics is to repair the damage done to the body by pregnancy. Stretch marks, hanging skin, loose muscles, loss of a waist and curves, sagging breasts, loss of breast size, and a change in body shape due to fat redistribution are among the most common complaints. While all of these can usually be fixed, it is important to know WHEN is the right time after giving birth.

There are many factors to consider, including breast feeding, if you are planning another child, if you had a c-section, and if weight loss is needed. Each factor goes into my decision making process, and each patient is different. Even child care needs have to be arranged prior to surgery.

For an uncomplicated pregnancy, vaginal delivery, no breast feeding, and a weight no more than 20 lbs over the patient’s goal with good child care plans and no future children desired, liposuction and fat transfers need to wait 3 months for the hormonal levels to regulate, as it can affect fat metabolism. For a breast surgery, you must wait at least a month after milk stops being able to be expressed. For a tummy tuck, 3 months is safest.

After a c-section, assuming no infections, the above listed times still are a good guideline. If you are breast feeding, and want a breast surgery, you need to stop and wait a month after milk is expressible. For nonbreast surgery, you need to either stop, or if you want to continue, you must pump and store milk prior to last 2 weeks, as the milk that comes out after surgery will have medications from surgery and pain control, and is not safe to give to a baby.

It is always best to be as close to your ideal weight as possible prior to surgery, with a max of 20 lbs over. If you lose significant weight after surgery, a tummy tuck might not be as tight, breasts may lose volume, as well as the buttocks.

If you want more children, it is sometimes smart to wait until after the last for a tummy tuck or breast surgery, as these are the spots that change the most. It is not harmful to you or your baby to be pregnant after a tummy tuck or breast surgery, but you may experience a cosmetic change. Liposuction is certainly safe and easy as well.

Hopefully this helps. There is a way to get back your pre-baby body!


Is Laser Surgery Better for Hispanic Patients?

Many patients come to Yager Esthetics after seeing an ad or hearing a television report about some type of laser that can magically eliminate stretch marks or scars, or tighten loose skin so you do not need surgery.  It sounds almost too good to be true.  Unfortunately, it IS too good to be true.

Lasers can do many things in medicine, even cosmetically.  Every year, advances really do occur that make them safer and more effective for patients.  They are not, however, magic.  I hope to demystify lasers for you a bit in this column.

You can cut with a laser as you can cut with a scalpel.  Both incisions leave a scar.  There is no evidence that laser incisions heal better.  In Hispanic skin, I feel the laser is more dangerous, as the heat it generates can cause hyperpigmentation (darkness) in the surrounding skin.  Advantage, scalpel.

Lasers do not remove stretch marks.  There is as of today no treatment, be it cream or laser or magic wand, that can erase a stretch mark from skin.  While early pink ones are easier to fade than old white ones, they do not disappear.  Again, in Hispanic skin, the risk is creating stretch marks with dark spots (manchas) around them.  The only current way to get rid of stretch marks 100% is to remove the skin that contains them.  For example, if your stretch marks are all below the belly button and you have enough skin, you can do an abdominoplasty, or tummy tuck to remove that skin.

Lasers are effective in permanently reducing unwanted hair.  Hispanic patients must seek out doctors with a lot of experience treating latin skin to avoid burns, darkness and other complications. The darker your skin, the greater the danger.

Please do not think I am anti laser – they fascinate me, and I have incorporated them in my practice.  I will continue to follow the advances, and add them when they are safe and effective for my Hispanic patients.