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Mommy Makeover

Also known as post-pregnancy surgery

A mommy makeover is any combination of cosmetic procedures that restore your before-pregnancy appearance, typically focusing on the breasts and abdomen. A typical makeover might include a tummy tuck, a breast procedure such as an augmentation, lift or reduction and liposuction of the legs, arms or trunk. The term “mommy makeover” may be new, but the procedures involved have a long, successful, and safe track record.

When to Consider a Mommy Makeover

• If your pregnancy has negatively affected the size and shape of your breasts
• If you’re distressed about your sagging tummy and stretch marks
• If pockets of fat on your waist, abdomen, arms or thighs do not improve with diet and exercise

Considerations

Pros

• Restores a more youthful bust and flat tummy
• Your clothes and swimwear will fit better
• Helps you return to a more youthful-looking body appearance

Cons

• If you get breast implants, they will require monitoring and possibly replacement.
• Pregnancy following these surgeries may compromise results.
• Weight gain following these surgeries may compromise results.

These are the top three pros and cons to weigh when considering a mommy makeover. If you want to focus on what is unique to you, please consult with your aesthetic plastic surgeon.

Are you a good candidate for a mommy makeover?

Mommy makeovers are designed to reverse the physical changes associated with childbearing and aging. If childbirth has left you with the following characteristics, consider undergoing a mommy makeover:

• You have sagging breasts, uneven breasts, decreased breast volume, drooping nipples and stretched areolas (the dark skin surrounding the nipple).
• Your breasts have become so much larger after childbirth that they are out of proportion with the rest of your body and they cause back pain.
• Your tummy has loose skin and stretch marks and your waistline has become thick and undefined.
• You had a C-section and now you have areas of fat hanging over your surgical scar.
• You have excess fat in the love-handle area as well as in the hips and thighs.
• You have early signs of aging in your face and around the eyes.

If you are in good general health and have a positive attitude and realistic expectations, you are most likely a good candidate for this procedure.

Mommy makeover is any series of procedures meant to refresh and renew your body affected by childbirth.

Detailed Procedural Info

How is a mommy makeover procedure performed?

Mommy makeover is a descriptive term, not a procedure, so your first step is to consult with your plastic surgeon and decide on the procedures you will undergo. The following procedures described below are common to mommy makeovers. You can find more extensive information on each procedure in the Smart Beauty Guide.

Tummy tuck – also known as abdominoplasty

What it does
A flabby abdomen results from fat, poor skin elasticity, excess skin, and stretching of the inner girdle of connective tissue (fascia) and abdominal muscles (rectus muscles), extending from the ribs to the pubic bone. This inner girdle, which holds the internal organs in place, gets stretched during pregnancy or weight gain and the stomach protrudes. Abdominoplasty removes loose, excess skin and fat and tightens slack fascia, removing stretch marks and excess skin in the lower abdomen below the belly button.

How it is done

• Your surgeon will remove most of the skin and fat between the belly button and pubic hair in a horizontal oval or elliptical shape.
• Then the fascia overlying the abdominal muscles is tightened with sutures.
• The skin around the belly button is repositioned and the belly button is brought out through a small incision and sutured in its normal position.
• The incision, which typically runs from hip to hip, is closed with sutures. This will leave a scar that falls along the natural crease within the bikini line. The length and visibility of the scar varies.

Liposuction – also known as lipoplasty

What it does
A tummy tuck may narrow your waist, but not your hips. Liposuction can improve the contour of flanks or hips, so the surgeon performing your mommy makeover will likely recommend liposuction of the hips and thighs at the same time as a tummy tuck. Liposuction is also effective in the chest, thighs, neck, upper arms, and knees.

How it is done

• During surgery, a sterile liquid will be injected along with a local anesthetic to control pain and epinephrine to minimize bleeding.
• After you receive anesthesia, your surgeon will make very small incisions near the area where fat will be removed.
• A thin, hollow rod (cannula) will be inserted through the incision to create tunnels through the fat. Then suction forces the fat into the cannula and out a high-vacuum hose.
• After fat removal, dressings and a compression garment will be applied.

Breast lift – also known as mastopexy

What it does
A breast lift or mastopexy treats sagging and uneven breasts, decreased breast volume, drooping nipples, and stretched areolas, returning a youthful shape and lift to your breasts. Women who desire larger, smaller, or more rounded breasts may want to consider a breast augmentation or breast reduction along with the breast lift.

How it is done

• You will receive either a general anesthetic or a combination of local anesthesia and intravenous sedation.
• Your surgeon will make incisions. Mastopexy incisions vary, depending on the amount of excess skin, the position of your nipples, your preference, and your surgeon’s suggestions.
• After making the incisions, the surgeon repositions and reshapes the breast tissue and surgically removes excess skin.
• Then the nipple and areola are repositioned to a more youthful height. (Note that nipples and areolas usually remain attached to underlying mounds of tissue, which usually allows for the preservation of sensation and the ability to breastfeed.) If needed, the size of the areola can be reduced by excising skin around the perimeter.
• Your surgeon will then tighten the remaining skin while closing the incisions. The sutures are layered deep within the breast tissue to support the newly-shaped breasts and may use skin adhesives and/or surgical tape to help close and support the skin.

Breast reduction

What it does
During pregnancy, your breasts usually swell to a fuller size and shape. In some women, the breasts remain larger. This can be a welcome change unless your breasts have become disproportionately large and cause pain, poor posture, rashes, breathing problems, skeletal deformities, or low self-esteem. Breast reduction solves these problems by removing fat and glandular tissue and tightening skin to produce smaller, lighter breasts.

How it is done

• Your surgeon will make incisions on your breasts and surgically remove excess fat, glandular tissue, and skin. (In some cases, excess fat may be removed through liposuction in conjunction with excision. If breast size is largely due to fatty tissue and not excess skin, liposuction alone may be used.)
• Depending on your surgeon’s recommendation, you may have intravenous sedation or general anesthesia.
• After deciding what is the best incision option for you, your surgeon will make the incision, reposition the nipple (which remains tethered to its original blood and nerve supply), and reduce the areola by excising skin at the perimeter, if necessary.
• Then he or she will reduce, lift, and shape underlying breast tissue and then bring the incisions together to reshape the now smaller breast. The sutures are layered within the breast tissue to create and support the newly-shaped breasts, and then the skin is closed with sutures, skin adhesives, and/or surgical tape.
• Your breasts will be wrapped in special gauze. You may be required to wear a surgical bra.

Breast augmentation – also known as augmentation mammaplasty

What it does
Breast augmentation increases or restores breast size using silicone gel implants, saline implants, or fat grafting.

How it is done

• In breast augmentation using implants, your surgeon makes an incision, lifts the breast tissue, creates a pocket in the chest/breast area, and places a saline or silicone gel implant.
• The implant is placed in a pocket underneath the pectoral muscle, which is located between the breast tissue and chest wall, or underneath the breast tissue and on top of the pectoral muscle.
• You will be wrapped in a gauze bandage or a surgical compression bra. Drainage tubes may be used for a short time to drain the surgical site.

Breast lift combined with breast augmentation

If you want your breasts to be larger in addition to being less droopy, or if you desire to maintain projection and roundness of the breast mound and your drooping is severe, your plastic surgeon may recommend a breast lift combined with a breast augmentation as part of your mommy makeover.

What are my options?

You have many options, beginning with your choice of which procedures to undergo.

• If you undergo breast augmentation, you will choose between silicone and saline breast implants, or, possibly, fat grafting. Depending on the size and shape you would like to achieve, your surgeon will give you some recommendations.
• If you undergo liposuction, your plastic surgeon will explain the many new technologies associated with it.
• In any of the mommy makeover surgeries, your preferences will be a deciding factor in incision placement as much as possible.

What will my mommy makeover incisions and scars be like?

Every effort will be made to make these as small and inconspicuous as possible. Plastic surgeons are adept at hiding them.

Tummy tuck: The incision stretches from hip to hip just above the pubic area. This will leave a scar that falls along the natural crease within the bikini line. Its length and visibility varies.

Liposuction: Because liposuction incisions are small, the scars are also small. Your surgeon will attempt to place them in hidden areas.

Breast lift: There are different types of breast lifts, each with different scarring patterns. Your surgeon can conceal some incision lines in natural breast contours, but others will be visible on the breast surface. Although incision lines are permanent, in most cases they will fade and significantly improve over time.

Breast reduction: There are at least four different incision patterns. Your pattern will depend on the size of your breasts, how much your breasts sag, and where your nipple-areola complex is positioned on your breast.

Breast augmentation: Your incision can be made in one of four places:

1. inframammary, underneath the breast
2. transaxillary, near the armpit, where the arm meets the chest area
3. transumbilical, in the belly button (only for saline implants)
4. periareolar, around the lower edge of the areola.

Selecting a Surgeon

Select a surgeon you can trust

It’s important to choose your surgeon based on:

• Education, training, and certification
• Experience with mommy makeover procedures
• Your comfort level with him or her

After finding a board-certified plastic surgeon in your area who is experienced in performing mommy makeovers, you will need to make an office appointment for your consultation. Generally, because of the in-depth nature of the consultation, there is a cost associated with the initial visit, which is sometimes deducted from the price of the procedure.

Your initial consultation appointment

During your initial consultation, you will have the opportunity to discuss what you want to achieve. Your surgeon will evaluate you as a candidate for a mommy makeover and clarify what procedures may benefit you most. Once he or she understands your goals, your surgeon may suggest additional or related procedures.

It is important to be completely honest during the consultation. Be fully prepared to answer these questions:

• Do you have any medical conditions or drug allergies? Are you being treated for any medical conditions?
• Have you had any previous surgeries?
• What are your current medications and vitamin and herbal supplements?
• What is your current use of alcohol, tobacco and recreational drugs?
• What is your history with any noninvasive cosmetic procedures?
• What outcome do you expect from the surgery? What is your chief motivation in undergoing a mommy makeover?

Your surgeon may also:

• Ask you to look in a mirror and point out exactly what you would like to see improved
• Take photos for your medical record, using computer imaging to show improvements you can expect
• Evaluate your health status, including pre-existing health conditions or risk factors
• Evaluate the elasticity of your skin
• Discuss your options and recommend a course of treatment
• Discuss likely outcomes, including risks or potential complications
• Discuss the type of anesthesia that will be used

Your treatment plan

Based on your goals, physical characteristics, and the surgeon’s years of training and experience, your surgeon will share recommendations and information with you, including:

• An approach to your surgery, including the combination of procedures
• The outcomes that you can anticipate
• Your financial investment in the procedure
• Associated risks and complications
• Options for anesthesia and surgery location
• What is needed to prepare for the surgery
• What you can expect to experience after surgery
• The doctor will also share before-and-after photos of cases similar to yours and answer any questions

Questions to ask your aesthetic plastic surgeon

We developed these questions to help you:

• Make the most informed and intelligent decision about your procedure
• Confirm that you have the right surgeon for your procedure
• Make your initial consultation as rewarding as possible
• Understand your options, potential outcomes and risks

It is important for you to take an active role in your surgery, so please use this list of questions as a starting point for your initial consultation.

• Am I a good candidate for a mommy makeover?
• Are the results I am seeking reasonable and realistic?
• Do you have before-and-after photos I can look at for the procedure I am undergoing?
• Where will my scars be located?
• What kind of anesthesia do you recommend for me?
• What will be the costs associated with my surgery?
• What will you expect of me to get the best results?
• What kind of recovery period can I expect and when can I resume normal activities?
• What are the risks and complications associated with my procedure?
• How are complications handled?
• What are my options if the cosmetic outcome of my surgery does not meet the goals we agreed on?

Preparing for Your Procedure

How do I prepare for a mommy makeover procedure?

Your surgeon will provide thorough preoperative instructions, answer any questions you may have, take a detailed medical history, and perform a physical exam to determine your fitness for surgery. If your surgeon recommends weight benchmarks or lifestyle changes, do your best to achieve them to ensure the best results and minimize the chance of complications. Regardless of the type of surgery to be performed, hydration is very important before and after surgery for safe recovery and critical outcomes. Since mommy makeover surgery places heavy demands on your body for wound healing, there are special recommendations:

• Achieve your desired target weight first, but not in the month before surgery.
• Make sure you are exercising at least thirty minutes per day.
• Be sure to have a healthy diet with a variety of vitamins, nutrients, and antioxidants.
• Keep alcohol consumption at less than two to three drinks per week.
• Stop smoking at least six weeks before undergoing surgery to promote better healing.
• Avoid taking aspirin, nonsteroidal anti-inflammatory medications (NSAIDs: Advil, Motrin, Aleve), and vitamins/homeopathic regimens that can increase bleeding.
• Establish a no-fail support system for the full recovery period dictated by your surgeon. This is most critical to your recovery. If you have children less than five years of age, you must have someone to take care of them for at least two weeks. Lifting, driving, laundry, and cleaning are absolutely prohibited.
• Prepare your home for recovery. Your doctor can suggest many conveniences that may help you, depending on your procedure. For example, if your mobility is limited, it may be helpful to move objects from high shelves.
• If your surgery is performed on an outpatient basis, arrange for someone to take you home and stay with you.

What can I expect on the day of mommy makeover surgery?
Your mommy makeover surgery may be performed in an accredited hospital, free-standing ambulatory facility, or office-based surgical suite. Your surgeon will give you an estimate of how long your surgery will last based on the procedures you have decided to undergo.

• You will receive medications to keep you comfortable during the surgical procedure. Local anesthesia combined with sedation may be an option, or you will receive general anesthesia. An anesthesiologist or nurse anesthetist will be present to administer sedatives or general anesthesia and assist in monitoring.
• For your safety during the surgery, various monitors will be used to check your heart, blood pressure, pulse, and the amount of oxygen circulating in your blood.
• Your plastic surgeon will follow the surgical plan discussed with you before surgery. Once the operation has begun, he or she may decide to combine various techniques or change a technique to ensure the best result. It is important that you feel comfortable and trust your doctor to make these decisions.
• Your surgical dressings will depend on the procedures you undergo and may include surgical drains.
• After surgery, you will be taken into a recovery area where you will continue to be closely monitored.
• Before leaving for home, you (or someone looking after you) should feel comfortable emptying and resetting the drains.

You may go home on the day of surgery or spend one or two nights in an aftercare center with a nurse unless you and your plastic surgeon have made other plans for your immediate postoperative recover.

Aftercare and Recovery

Your surgeon will discuss how long it will be before you can return to your normal level of activity and work. After surgery, you and your caregiver will receive detailed instructions about your postsurgical care, including information about:

• Drains, if they have been placed
• Normal symptoms you will experience
• Any potential signs of complications

Immediately after a mommy makeover
For thorough information, read about the procedures you will be undergoing visit sections on abdominoplasty, liposuction, breast lift, breast reduction, and breast augmentation.

• Generally, you can expect to be bandaged, wearing compression garments, and you may have some surgical drains.
• When the anesthesia wears off, you may have some pain. If the pain is extreme or lasts long, contact your physician. You will also have some swelling after the surgery. In some cases, this swelling will remain for weeks or even months. Contact your physician to find out if your pain and swelling is normal or a sign of a problem.

Recovery time frame
Because procedures are performed together, the benefit is that you only have to endure one recovery time. The first week will be the worst, and you will still feel like you are recovering for about two to three weeks. After that, you’ll probably be feeling pretty well, but you will not be able to do any heavy lifting (such as picking up your children) for six weeks. Here is more information about what to expect:

• The recovery period is significant and can be intense the first few days. We recommend that you speak with your surgeon about using a pain pump as well as medications to control pain and discomfort, so that you can move about and sleep as needed.
• The tummy tuck component of the makeover is the most uncomfortable. Make sure you follow your surgeon’s instructions carefully. The first two days are the most uncomfortable. Discomfort typically drops down to a “nagging” level by five to seven days.
• Full recovery is about six weeks. You should be up and walking slowly the day after surgery.
• By the end of the first week, you should be walking around the house frequently, but you are still unable to drive.
• You will probably be comfortable enough to drive a car in two weeks, when all of the sutures and drains will be removed.
• You will likely go back for follow-up evaluation with your surgeon within five days. During this visit, your doctor can remove the drainage tubes. Swelling should subside within five weeks, and the results are apparent within three months.
• Having both procedures done at the same time does not lengthen the recovery. For example, breast augmentation recovery is approximately seven days, and tummy tuck recovery is ten to fourteen days. Your recovery period for both procedures will be in the ten to fourteen days.

Healing from mommy makeover surgery
Follow all postsurgical instructions. This will include information about wearing compression garments, taking any medications prescribed, and the level of activity that is safe. Your doctor will alert you to the signs of problems to watch for, such as signs of infection. It is important to realize that the amount of time it takes for recovery varies based on what your mommy makeover entails. However, there are some basic precautions and instructions that you should follow to help this recovery go as smoothly as possible, including:

• Arrange for someone to help you get around the house and help with your medication for at least the first twenty-four hours after surgery.
• Make sure you continue to have lots of help at home—this cannot be stressed enough. You’ll be tempted to try to help around the house quickly, but you won’t feel like yourself for at least seven days (ten to fourteen in many cases) and you still shouldn’t do any heavy lifting for four to six weeks. If you have small children, you must put someone else totally in charge of their care for two weeks.
• Try sleeping with several pillows under your back and keep your legs slightly bent at the hips to minimize the tension on your incision, reduce pain, and facilitate a thinner scar.
• Call your surgeon immediately if you notice an increase in swelling, pain, redness, drainage, or bleeding in the surgical area, or if you develop fever, dizziness, nausea, or vomiting. Other red flags include shortness of breath, chest pains, and unusual heartbeat.
• Your surgeon will likely supply you with a surgical bra to wear early in your recovery after breast reduction or breast lift. This will help minimize swelling. Most swelling should subside within a few weeks, although some swelling may persist for up to four months after breast reduction.
• You will need to wear an abdominal binder during your tummy tuck recovery. You may shower after the dressing, sponges, and gauze pads are removed. This usually occurs within seventy-two hours of your mommy makeover. After showering, pat your incisions dry and replace your abdominal binder.
• Avoid heavy lifting, contact sports, and jogging for up to six weeks.

How Long Will the Results Last?

Barring another pregnancy or significant weight gain, your results should be permanent, though plastic surgery cannot stop you from normal aging. However, breast implants are not permanent and there will likely come a time when you will have to replace them.

Maintain a relationship with your aesthetic plastic surgeon
For safety as well as the most beautiful and healthy outcome, it’s important to return to your plastic surgeon’s office for follow-up evaluation at prescribed times and whenever you have any questions about your mommy makeover healing and results. Do not hesitate to contact your surgeon when you have any questions or concerns.

Associated Costs

The cost of a mommy makeover varies from doctor to doctor, from one geographic area to another and based on the techniques involved. The biggest factor will be the number and kind of procedures you undergo.

Because a mommy makeover is elective surgery, insurance does not cover these costs (with the possible exception of a breast reduction). Many surgeons offer patient financing plans to make the procedure more affordable. It is important to understand that you will generally pay less for a mommy makeover than if you have the procedures done individually.

Choose your surgeon based on quality, training, and experience—not cost.

Limitations and Risks

Fortunately, serious risks of mommy makeover surgeries are rare and the satisfaction rate with these procedures is high. Your specific risks will be discussed during your consultation. The overall complication rate is small if the operation is performed by an experienced plastic surgeon operating in an accredited facility.

All surgical procedures have some degree of risk. Some of the potential complications of all surgeries are:

• Adverse reaction to anesthesia
• Hematoma or seroma (an accumulation of blood or fluid under the skin that may require removal)
• Infection and bleeding
• Changes in skin sensation
• Scarring
• Allergic reactions
• Damage to underlying structures
• Unsatisfactory results that may necessitate additional procedures
• Blood clots in the legs or lungs

You can help minimize certain risks by following the advice and instructions of your board-certified plastic surgeon, both before and after your mommy makeover.

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