What is a "Mommy Makeover"?
What is a "Mommy Makeover?"
Since motherhood significantly alters two important areas of your body, your breasts and your abdomen, most people think of a "mommy makeover" as a breast augmentation and/or lift, and a tummy tuck. The fact is, pregnancy induces so many changes all over a woman's body, and these changes vary considerably from one woman to another. My definition for the term "mommy makeover" is "any procedure or combination of procedures that will either give you back the body you had prior to having children or give you the body that you always wanted and dreamed of, but never had". I think you can even expand this to any woman, not just those who have borne children. Why discriminate??
How pregnancy affects your body
A woman's breasts, for instance, usually get larger as they get ready to lactate and then smaller after lactation ceases, often times leaving the breasts with less volume, reduced firmness and more skin than before pregnancy. As these changes occur to differing degrees in various women, as well as the fact that the breast's ability to recover from these alterations also vary from woman to woman, and not withstanding the fact that breasts are of many different sizes and shapes to begin with, women need options when it comes to breast rejuvenation. Sometimes a woman just requires some extra volume to rejuvenate her breasts (breast augmentation), but sometimes all that extra skin leaves the breast very underfilled and sagging, thus resulting in requests for a breast lift or breast augmentation and a lift. Other women who are perhaps, well endowed in this area to begin with find themselves maybe even larger after pregnancy or now the breasts are not as perky and are heavy and sagging thus needing a reduction in size.
The abdomen is an area that is a great cause of concern for many of my patients. As pregnancy progresses, both the womb enlarges and various hormones are released to ready the mother's body for the upcoming big day. These hormones relax ligaments and other elastic tissue to make a miracle happen - the delivery of her child! The problem is that as the abdominal wall is massively stretched and the abdominal skin follows similarly, they usually do not revert to their pre-pregnancy dimensions and tissue quality after the blessed event is over. The abdominal muscles, while perhaps a little stretched, are not the real culprit here. There is a layer of thin, strong, connective tissue called "fascia" that envelopes the abdominal wall muscles, especially on the anterior or front side of them. This tissue stretches during pregnancy under the influence of the hormonal changes and enlarging uterus. The result is the abdominal muscles, particularly the two vertical muscles in the midline, the rectus abdominus, begin to separate, giving that bulge that won't go away. The excess abdominal skin that won't retract adds to the problem. Also, consider the fact that women tend to carry their excess fat above their abdominal wall (unlike men who tend to carry it inside the abdomen) - this is a good thing because the plastic surgeon can address this fat during an abdominoplasty (tummy tuck) or liposuction.
Lastly, even the genitalia change after pregnancy. The labia minora, the inner lips of the vulva sometimes enlarge and/or thicken. This can lead to concerns about appearance, discomfort during intercourse as the skin is pulled inwards, discomfort during certain activities, and irritation in clothing. The procedure to correct this is called a "labiaplasty" (labia meaning "lip").
Most women are focus upon their abdomen. However, as I learned to think more in three dimensions as well as artistically, I began to look at the relationship between the abdomen in front, the flanks in the back which extend anteriorly (frontwards) as they blend into the lateral (sides) abdomen. From the back, going from top to bottom, I look for excess fat in the upper outer back, mid-back rolls of skin and fat under the bra strap and a midline fat pad just above the buttocks. The buttocks should be round, but often becomes square-ish as the upper hip bone area gains fat, the hip joint just below loses volume and the outer thighs gain fat. The buttocks look deflated as they lose volume and its normal convexity flattens. Of course there are considerable variations of this pattern. Let's not forget the upper arms and inner thighs as well!
MY approach to rejuvenating a woman's body
I have spent the past twenty years helping women to feel more confident, more comfortable in their own skin, so to say by offering them an array of surgical and non-surgical options. The best thing for you to do is think about what bothers you, what you would like to change and how you would like to do so, and then prioritize your choices into those that you wish to do sooner and those that you are more willing to do later. This may be for financial reasons or possibly you desire too many different procedures to have performed at the same time for medical or safety reasons.
You can pick any one or combination of procedures and call it a "mommy makeover". You don't even have to be a mommy to have it!!! I have seen just more permutations of these than you can imagine. One of the most interesting combinations recently was a woman who underwent the combination of "otoplasty (ear pinning) and labiaplasty". With "mommy makeover" anything goes! Anything as long as it is safe.
Meet the doctor Dr. Mark EpsteinDr. Mark D. Epstein is a board-certified plastic surgeon with additional qualifications in surgery of the hand, currently practicing in Stony Brook, New York. Dr. Epstein also serves as the Chief ... » Learn More
Safety and "Mommy Makeovers"
Safety is first over everything else. This is surgery, not a game. You are placing your life in my hands. I take this very seriously. When combining procedures, it is my job to consider the total amount of surgical and anesthesia time, anticipated recovery from each procedure, discomfort from each procedure, your occupation and how much time you can take off work, what responsibilities you have at home and your family/friends support system. Sometimes, it may be best to break the procedures up into two different surgical dates.
what procedures constitute a "Mommy Makeover"?
Here is an array of options to choose from. I have broken the procedures up by region. Many women often choose more than one procedure from each region to undergo simultaneously. This list is by far NOT all-inclusive.
Body: Tummy tuck (standard, mini, extended, circumferential), VASER Lipo-Tummy tuck (lipoabdominoplasty), VASER liposuction of the flanks, back, arms, thighs (inner and/or outer), fat transfer to buttocks (BBL - "Brazilian butt lift") and hips, VASER Smooth Cellulite reduction, labiaplasty (remove excess skin from the genital area)
When is it best to undergo a "mommy makeover"?
After childbirth, your body needs to stabilize. If you are currently lactating, I would not recommend surgery as you will receive various medications (anesthesia, antibiotics, medication for discomfort, etc. You certainly do not want these in your system and passed to your child in your milk. The aforementioned issues aside, lactation in and of itself is a contraindication for breast augmentation. If you are planning on losing weight, you should do so before surgery. Surgery, even cosmetic surgery, is a stress on the body so if there are any emotional issues, (i.e. postpartum depression), these should be addressed prior to committing to any surgery. Following surgery, it is vey common to have some emotional highs and lows and we advise out patients of this prior to surgery. These emotional changes, fortunately, are brief.
So in summary, you want to be at your baseline emotionally and physically after childbirth, or as much as possible. Chronic depression (most of my patients with this are on some type of oral anti-depressant) is not a contraindication to surgery, but if you have temporary postpartum depression, then you really should wait until that is resolved before moving forward with the decision to undergo surgery.