The Mysterious 2fer

friend of mine once mentioned a little something called a “2fer”, as in a two-for-one surgery combining a c-section and tummy tuck.

From that point on, it seemed to me that every celebrity who delivered a baby did so by c-section, and then popped up on the cover of magazines with taut tummies.

It got me thinking: is there something to this? Should the rest of us feel bad that we’re told we’ll leave the hospital looking five months pregnant? Or were the stars getting a little nip/tuck action?  

It was time to put on my investigative hat (in other words, pick up the phone) and call celebrity delivery central: Cedars-Sinai Medical Center in Beverly Hills.

I was quickly told by their media relations department that their staff of OB’s do not comment on this issue. Interesting.

Plastic surgeons, on the other hand, have no issue with commenting. Even online.

Plastic surgeon Michael Bermant’s web site clearly states that, “Elective tummy tuck surgery at time of birth is not a good idea.” He explains that a woman’s hormones during pregnancy change the body’s tissue to ease delivery, and “[t]hese distended tissues have not yet shown what laxity will remain.”

Next stop: The Center for Cosmetic Surgery. They echoed Dr. Bermant’s statement, saying that a tummy tuck should not be performed until after you are fully healed from your c-section. They note that optimal results are obtained after the pregnancy weight is lost and the body has “stabilized”. They recognize the convenience of having both procedures done at once, but quickly point out how “studies show that the complications from surgery increase when combining these two procedures.” 

Arguably those statements could be financially motivated — if obstetricians were performing these so-called “2fers,” plastic surgeons could be losing out on lucrative tummy tuck procedures.

So, what did the OBs really think?

It was time to go straight to the source: Dr. Jason Rothbart, who was flown to Swakopmund, Namibia to deliver Angelina Jolie and Brad Pitt’s baby. While he acknowledged that c-section deliveries are up this year by 25%, he said a likely reason is because, “More and more doctors are making medical decisions — sometimes for legal reasons — to save lives, [for example] if they notice a rapid drop in the baby’s heartbeat.”

When asked his opinion about why so many celebrities have C-sections he said, “Some are probably for a reason the public doesn’t know about. For example, the baby is breach and the public just assumes it was elective when it was medically necessary.”

Going on to push the envelope, I asked him straight out if he’s ever done a “2fer.” “No,” he replied firmly. “I don’t combine an elective procedure. It’s dangerous to do. It’s a totally separate procedure. I wouldn’t recommend a person having a tummy tuck — that wouldn’t be an option.”

It was looking more and more like the "2fer" didn’t exist.

So, I headed back to my friend, and asked this taut-tummied mother-of-three if there was really something to this, something that no one would admit to me. She told me that she asked her doctor about the “2fer” before her third child was born via cesarean delivery. “He said, ‘I'll take as much scar tissue out as I can.’ But it wasn't a full tummy tuck. And actually, he said I didn't have that much scar tissue.” Aha! A mini tummy tuck perhaps?

I needed to ask Dr. Rothbart about this. He informed me that he would remove any scar tissue that was found in the area of the c-section incision from a previous surgery. He further explained, “Whether this can be thought of as a tummy tuck I’m not sure, because it's just the focused area and not the wide incision across the entire abdomen that a tummy tuck (abdominoplasty) entails.”

In layman’s terms, she only had scar tissue as a result of having had three c-sections.