Under The Belly Bulge

A Must-Read For Every Woman After Pregnancy Phase

Patient Case Scenario 1. “Doc, I need help”, a 45 yr old lady, a professor of chemistry, was speaking. 

“After my pregnancy, I landed up with this big bulgy and saggy tummy. I could never reduce it with diet and exercise. I do all the work at home and office with this burden. I have to wear sarees only. Jeans? Impossible. Kurta salwar? A big No. 

My belly looks like I am pregnant. Embarrassing! And, the other day, an auto-rickshaw driver slowed to a crawl when I went to the office… 

My back and knees hurt after a day’s work. I feel so guilty I cannot diet enough. I don’t need a model or actress-type body, but can I never hope for a decent shape?”

Patient Case Scenario 2. An elderly lady was pouring out her heart “ After delivery, I was stuck with this tummy. My knees hurt. The ortho doctor says I need knee replacement only after losing weight. 

For years, I have been regular with yoga and walking.  I never really overdid on sweets or fats. Yet Today, I find it impossible to keep up with my grandkids!”

Belly Bulge- Affecting Every Woman After Pregnancy

These scenarios are playing out in so many households. The ladies have to bear the indignity of comparison with some fortunate slim acquaintances and put up with the blame heaped upon them for not controlling eating and not working out enough. 

At the other extreme, overprotective husbands assure them: “But I love you as you are! Why do you need liposuction?”

Senior ladies of the household turn up their noses at the idea of going under the knife for such things. “Surgery is dangerous, No? Such fads never came up in our time! It’s just a scam by doctors to make money!”

The problem of the large tummy needs to be solved. It must be regarded not as a cosmetic procedure but as a necessary health intervention. This change must occur, not just in the eyes of society but also in the government, which has applied GST to the operation charges, classifying it with cosmetic procedures!

Let us first understand the structure of the tummy. 

The tummy is like a tent, attached above the rib cage and below the pelvic bones. The skin of the tummy is thicker over the back and thinner on the front and sides. The belly button is actually the scar where your umbilical cord was attached before birth.

The skin is attached firmly to the backbone and the ribs above and to some points on the pelvic bones below. Everywhere else, it is looser and sliding.

There are two layers of fat tissue under the skin, with a fibrous layer called fascia separating them. The lower layer is the thick one. 

Under the skin and fat layers, we find muscles. Two straight muscles run from the ribs above to the front of the pelvis below, attached to the bone just above the pubes. These lie on either side of the belly button. Then on the outer sides, there are oblique muscles curving around the body from the backbone behind, coming up front to form a stitch in the midline from top to bottom. 

These muscle layers create those six-pack ridges you admire in your favourite action hero! Women who have good muscles can also have such ridges, but there is more fat under the skin on ladies, especially below the belly button, so six-packs aren’t that easy to see in women. In women, we see lateral highlights, depression on either side of the belly button, a cinched waist, a carved midline depression and a gentle lower belly bulge.

The innermost layer, below the muscles, is a membrane called the peritoneum. This membrane covers the intestines and runs along the inside of the entire cavity of the tummy.

Naturally, there are various organs such as kidneys, pancreas along the back of the inside of the tummy, and the liver, spleen, intestines, and urinary bladder in front. Plus, of course, the ovaries and uterus in women.

The entire tummy is separated from the chest above by a muscle, the diaphragm. This muscle moves down when one breathes in. So the tummy muscles also relax, allowing the belly contents to move outwards. The tummy goes in when breathing out, and the diaphragm moves up. You can easily observe the movements of the belly of a sleeping baby and understand the patterns.