Pregnancy stretch marks are caused by rapid stretching of all skin layers due to the increasing mammary gland size. It is believed that almost 85% of pregnant women are affected by continuous stretching of the skin and the tearing of elastic fibers in its deep layers at the beginning of the third trimester (this period is called the period of continuous stretching).
The skin’s weakening structure and the change of its elastic properties during pregnancy occur as a result of an increase in the concentration of glucocorticoid hormones that affects the formation of fibroblasts in the epidermis. Reduction in the number of fibroblasts decreases the production of collagen and elastin, which makes the supporting structures of the skin more fragile to stretching and reduces their strength. These skin changes ultimately lead to the appearance of reddish or violet bands that tend to gradually fade to lighter colors. They may become less visible over time but never disappear completely, which causes aesthetic issues in women after childbirth.
The development of stretch marks is undoubtedly related to the hormonal changes of pregnancy, as well as to the rapid growth during puberty or weight gain during bodybuilding.
Various types of treatment have been invented to improve the appearance of the skin in the stretch marks area, including laser techniques, dermabrasion, and drugs (retinoids).
• Laser therapy makes it possible to obtain a definite positive effect from the use of pulsed lasers with a wavelength of 585 nm. The greatest effect is provided by bipolar and tripolar laser devices.
• There is the possibility of cosmetic treatment of stretch marks with the help of fractional CO2 laser resurfacing. The use of this method is limited to a small number of published scientific papers. A noticeable effect is expected in 70% of cases after five procedures of fractional CO2 laser resurfacing during a month.
• Many patients get interested in stretch mark creams at the stage of the initial formation of the intradermal rupture, or even some time after its formation. There are practically no objective studies that would demonstrate significant results. Some studies show that the daily use of a cream containing Centella asiatica extract, vitamin E and collagen hydrolysates was associated with the appearance of fewer stretch marks during pregnancy. Combinations of cocoa butter, vitamin E, panthenol, hyaluronic acid, elastin and menthol also showed minor positive effect. To date, one thing is clear: the use of creams is associated with the appearance of fewer stretch marks during pregnancy as compared with no preventive use of creams.
• Some cosmeticians use carboxytherapy - intradermal injections of carbon dioxide – to reduce or eliminate stretch marks. This method can be considered a form of mesotherapy. Such injections improve the metabolism and oxygen supply in the stretch marks area, which promotes the synthesis of collagen smoothing and reducing the bands of intradermal ruptures. Carbon dioxide (CO2) is injected through a tiny needle measuring 0.3 mm in diameter. Unfortunately, there is only a small number of publications about this technique in the scientific literature, and it rarely allows to completely eliminate the stretch marks.
Stretch marks can be eliminated completely and reliably only by surgically removing the skin area where they formed. One of the effective methods of surgical treatment of stretch marks in women after pregnancy is breast lifting. During the surgery, the doctor can remove excess skin, excise the stretch mark areas and make the breast look fit again. Breast lifting can be combined with breast augmentation or breast reduction.
In cases of the mammary glands sagging down after pregnancy, stretch marks, excess skin and enlarged nipples, breast lifting can be combined with areoloplasty.
Some women develop breast pseudoptosis after pregnancy and breastfeeding. In this condition, the mammary gland decreases in volume and looks elongated, flattened and lowered. The nipples are located below the level of the inframammary fold, so the problem cannot be eliminated by breast lifting. Usually, with pseudoptosis, a good effect is achieved by mammoplasty with breast enlargement using implants. During the surgery, the doctor can also relieve the woman from stretch marks by removing the patches of altered skin.
Thus, mammoplasty can completely solve not only the stretch marks problem, but also other cosmetic issues arising after pregnancy and childbirth.