What is a Mommy Makeover?
After child bearing, many women are dissatisfied with the appearance of their body. Pregnancy and breastfeeding can have a negative impact on the breasts and abdomen. Many mothers find they have breasts that have changed in volume and are sagging. The abdominal skin may have stretch marks and be loose. Women who have undergone C-section deliveries often note a “shelf” of loose skin above their scar. Despite their efforts at dieting and exercise, these problem spots persist. Many women desire to return to their pre-pregnancy form. A mommy makeover is the plastic surgeon’s effort to achieve this goal. The surgery usually involves improving the breasts by replacing the lost volume with a breast implant. If the position of the nipples has dropped too much, then a breast lift may be recommended. Sometimes both an implant and a lift are necessary to center the nipple, improve breast volume, and achieve better cleavage. The abdomen is improved by performing a tummy tuck (abdominoplasty) which removes the excess skin and some of the stretch marks and tightens the abdominal muscles which may have been stretched apart by the pregnancy. Liposuction maybe performed on excessively full fatty areas.
What it won’t do
A mommy makeover is not a substitute for weight loss or exercising to achieve the appropriate muscle tone. While the results of a mommy makeover are technically permanent, your body’s appearance can be affected by significant weight fluctuations or additional pregnancies. Ideal candidates for a mommy makeover are women who have completed their childbearing, and who are at or as close as they can get to their ideal weight. The trade-off in improving your shape is the addition of permanent scars to your body. Stretch marks that are above the level of the belly button and lateral to the hips will remain after a tummy tuck, but because the surrounding skin is tightened, they may be less obvious.
The success and safety of your mommy makeover depends very much on your complete candidness during your consultation. You’ll be asked a number of questions about your health, desired outcome and lifestyle. During your consultation be prepared to discuss:
• Your surgical goals
• Medical conditions, drug allergies, and medical treatments
• Current medications, vitamins, herbal supplements, alcohol, tobacco, and drug use
• Previous surgeries Is it right for me?
A mommy makeover surgery is a highly individualized procedure and you should do it for yourself, not to try to fit any sort of ideal image or to fulfill someone else’s expectations.
A mommy makeover is a good option for you if:
• You are physically healthy, at a stable weight and are committed to leading a healthy lifestyle with proper nutrition and fitness
• You have realistic expectations
• You are a non-smoker
• You are bothered by the appearance of your abdomen and breasts
• You are done having children and are not planning on having any future pregnancies
• You do not have any medical conditions that could impair healing or increase the risk of surgery
• You have a positive outlook
• You are bothered by the feeling that your breasts sag or have lost shape and volume
• Your breasts have a flatter, elongated shape or are pendulous
• When unsupported, your nipples fall below the breast crease
• Your nipples and areolas point downward
• You have stretched skin and enlarged areolas
• One breast is lower than the other
Your surgeon will also:
• Evaluate your general health status and any pre-existing health conditions or risk factors
• Take photographs
• Discuss your options
• Recommend a course of treatment
• Discuss likely outcomes of the mommy makeover and any risks or potential complications
• Discuss the use of anesthesia during your surgery
• Examine your breasts and may take detailed measurements of their size and shape, skin quality, and placement of your nipples and areolas
Prior to surgery, you may be asked to:
• Get lab testing or a medical evaluation
• Take certain medications or adjust your current medications
• Stop smoking
• Avoid taking aspirin, anti-inflammatory drugs, and herbal supplements as they can increase bleeding
Your mommy makeover will be performed on an outpatient basis, so be sure to arrange for someone to drive you to and from surgery and to stay with you for at least the first night following surgery.
During Your Procedure
Step 1 – Anesthesia
Medications are administered for your comfort during the surgical procedure. The choices include intravenous sedation and general anesthesia. Your doctor will recommend the best choice for you.
Step 2 – Tummy Tuck Incision
A tummy tuck involves the surgical removal of excess abdominal fat and skin and includes tightening of the abdominal wall where muscles have weakened.
A full tummy tuck requires a horizontally-oriented incision in the area between the pubic hairline and belly button. The shape and length of the incision will be determined by the amount of excess skin. Once the abdominal skin is lifted, the underlying weakened abdominal muscles are repaired. A second incision around the navel may be necessary to remove excess skin in the upper abdomen. The upper abdominal skin is pulled down like a window shade. The excess skin is trimmed and the remaining skin is sutured together. A new opening for the belly button is created. The belly button is popped through to the surface and sutured into position.
Step 3 – The Breast Lift Incision
During the breast lift part of the surgery, excess skin is surgically removed to raise the nipple and tighten the breast tissue. Incision patterns vary, depending on degree of excess skin and the amount of lifting required as well as patient and surgeon preference. There are three common incision patterns:
• Around the areola
• Around the areola and vertically down from the areola to the breast crease
• Around the areola, vertically down from the breast crease and horizontally along the breast crease
Step 4 – Reshaping Your Breasts
After your doctor makes the incisions:
• The underlying breast tissue is lifted and reshaped to improve breast contour and firmness.
• The nipple and areola are repositioned to a natural, more youthful height.
• If necessary, enlarged areolas are reduced by excising skin at the perimeter.
• Excess breast skin is removed to compensate for a loss of elasticity.
Some women may want to consider placement of a breast implant in addition to the breast lift. An implant can provide improved upper breast fullness or cleavage. Implants can be placed at the same time or as a second procedure, depending on the experience of the surgeon. If you have simply lost breast volume, but the size of the breast skin envelope and the position of the nipple is still good, your surgeon may recommend simply placing a breast implant. Available implants can be filled with silicone or saline. Implants can be placed beneath the breast tissue itself, or under the pectoral muscle. Various incision sites are possible. Depending on your anatomy and personal preference, your surgeon will recommend an implant type and size.
Step 5 – Closing The Incisions
Sutures are layered deep within the breast tissue and the abdomen to create and support the newly shaped breasts and abdomen. After your breasts and abdomen are reshaped and excess skin is removed, the remaining skin is tightened as the incisions are closed with sutures, skin adhesives, tapes or clips. Drains may be placed under the skin to remove any weeping blood or serum after the surgery. The drain will remain until this weeping stops, usually one to three weeks. You will be asked to empty and record the volume of drainage so that your surgeon can know when it is safe to remove the drain. You will often be asked to wear a compression garment (girdle) after abdominal surgery, to minimize the bruising and swelling, for a few weeks. Your surgeon will try to make sure that all of your breast and abdominal scars are hidden beneath your underwear or a bathing suit. However when you are naked, these scars will be visible. While your plastic surgeon will do everything possible to assure you get the best possible scar, scar formation depends on your own genetics and wound healing capabilities. Scars do tend to improve over time, but it may be months to years before the scars fade as much as they will.
After your mommy makeover is completed, dressings or bandages will be applied to the incisions. You’ll need to wear an elastic bandage, support bra, or a compression garment to minimize swelling and support your body as it heals. Small, thin tubes may be temporarily placed under the skin to drain any excess blood or fluid that may collect. You will be given specific instructions that may include how to care for your body following surgery, medications to apply or take orally to aid healing and reduce the potential for infection, specific concerns to look for at the surgical site or in your general health, and when to follow up with your plastic surgeon. Be sure to ask your plastic surgeon specific questions about what you can expect during your individual recovery period:
• Where will I be taken after my surgery is complete?
• What medication will I be given or prescribed after surgery?
• Will I have dressings/bandages after surgery?
• When will they be removed?
• Are stitches removed? When?
• When can I resume normal activity and exercise?
• When do I return for follow-up care?
• How will I bathe?
• How long will I wear the pressure garment?
• Will the drains be removed?
The decision to have a mommy makeover is extremely personal, and you’ll have to decide if the benefits will achieve your goals and if the risks and potential complications are acceptable. You will be asked to sign consent forms to ensure that you fully understand the procedure and any risks. The risks include:
• Anesthesia risks
• Fluid accumulation (seroma)
• Poor wound healing
• Skin loss
• Numbness or other changes in skin sensation
• Skin discoloration and/or prolonged swelling
• Unfavorable scarring
• Recurrent looseness of skin
• Fatty tissue found deep in the skin might die (fat necrosis)
• Deep vein thrombosis, cardiac and pulmonary complications
• Breast asymmetry
• Suboptimal aesthetic result
• Possibility of revisional surgery
• Persistent pain • Bleeding or hematoma formation
• Poor healing of incisions
• Changes in nipple or breast sensation, which may be temporary or permanent
• Breast contour and shape irregularities
• Potential partial or total loss of nipple and areola
Risks related to breast implants:
• Implant leakage or rupture
• The formation of tight scar tissue around the implant (capsular contracture)
• Wrong or faulty position of the implant
These risks and others will be fully discussed prior to your consent. It’s important that you address all your questions directly with your plastic surgeon.
The results of your mommy makeover surgery are immediately visible. Over time, post-surgical swelling will resolve and incision lines will fade. Satisfaction with your new image should continue to grow as you recover from surgery. The final results of your mommy makeover may be initially obscured by swelling and your inability to stand fully upright until internal healing is complete. Your final results will appear over the next few months as your breasts’ shape and position continue to settle. Previous abdominal surgery may limit the potential results of a mommy makeover. In women who have undergone cesarean section, the existing scars may be incorporated into the new scar. Incision lines are permanent but will continue to fade over time. Your scars may take several months to a year to fade as much as they will. The results of your mommy makeover surgery will be long lasting. Over time, your body can continue to change due to aging and gravity. You’ll be able to retain your new look longer if you:
• Maintain your weight
• Keep a healthy lifestyle
Although good results are expected from your procedure, there is no guarantee. In some situations, it may not be possible to achieve optimal results with a single surgical procedure and another surgery may be necessary.
Special note: A mommy makeover should be entertained after childbearing is completed. Changes that occur in the breasts and abdomen during pregnancy can minimize or reverse the improvement a mommy makeover provides. Likewise, significant weight loss after a mommy makeover can negatively impact breast appearance.