Mommy Makeover is a descriptive term that has worked its way into the plastic surgery nomenclature in a very short time. Introduced just a few years, women are increasingly requesting this type of surgery. While the term may be recent, the plastic surgery operations used in it have been around for over half a century. To help reverse the effects of pregancies, a Mommy Makeover combines two or more plastic surgery procedures in a single operation…most commonly breast and abdominal reshaping. Here are some of the most common questions asked about a Mommy Makeover.

What is A Good Age For A Mommy Makeover?

In theory, it can be done at almost any age. But, by far, the majority of these procedures are done between the ages of 35 to 50. This is an age range where women are done having children and have proven to themselves that diet and exercise just can’t get the body improvement they desire. Coincidentally plastic surgery statistics show that the majority of aesthetic surgery is done in patients over the age of 35 years old.

How Soon After Pregnancy Can I Have Surgery?

Some women want the procedure done just as soon after delivery as possible. But one should be fully recovered from pregnancy and have lost much of their baby weight. This means that the minimum time is 3 months after pregnancy, six months is even better. One should also be finished breastfeeding.

Why Can’t Diet And Exercise Remake My Post-Pregnancy Body?

The effects that pregancy has on a woman’s body are largely irreversible in many cases by natural efforts for many women. Loose or separated abdominal muscles (rectus diastasis) can not be made to fuse back together by any amount of abdominal situps. Abdominal skin that has been stretched out and partially torn (stretch marks) can not hav elasticity restored by situps, creams or weight loss. Breasts that have lost volume and sag can not be lifted up by chest exercises or alleged skin tightening creams. The thing a women can do is lose her pregnancy weight but all other changes require outside help.

What Are The Benefits Of A Mommy Makeover?

The benefits of choosing a Mommy Makeover versus several separate procedures: Depending on the procedures selected, combining surgeries can reduce cost by several thousand dollars. When combining two surgeries in a mommy makeover, patients are only charged one operating room fee and anesthesia fee instead of two! The most common mommy makeover combines a breast augmentation and a tummy tuck. By opting to have these surgeries performed at once, you can reduce your recovery time by as many as six weeks. Cost and time savings not enough? 68% of female body contouring patients noticed an improvement in their sex life after the procedure.

What Is The Recovery From A Mommy Makeover?

Because it is combining procedures, the recovery time is addictive and longer than most projections state. A general statement often made is that one will need at least two weeks off of work to recover before returning to normal activities. Such a statement is the absolute minimum time and represents an underestimation for most women. The recovery prediction should be pushed up to a minimum of three weeks or longer. While the recovery will vary based on the procedures done and the individual woman, the common Mommy Makeover of a breast implant and/ or lift with some form of a tummy tuck is lot closer to three weeks than two…and even then this phase of recovery is about performing a minimal level of daily and work activities.

Dr. Barry Eppley

Indianapolis, Indiana

A woman’s hormones are well known to change as they age. Women over age 40 will have a decrease in such hormones as estrogen and oxytocin while testoterone increases. This can lead to an increase in one’s sex drive. But the post-pregnancy bodies of many women over 40 leave them feeling very self-consicous with loose abdominal skin and saggy and smaller breasts. This may partially account for why up to 15% of married couples report that they have not had sex in the past six months or even a year. This is where the Mommy Makeover can be of benefit. By combining several body reshaping procedures in a single operation a dramatic improvement in a woman’s body altered by pregancy can occur. The most common Mommy Makeover combines a breast augmentation often with a breast lift and a tummy tuck. By putting these two procedures together one can reduce not only cost but recovery time by as much as one month than if they were done separately. But if cost and recovery is not enough, almost three-quarters of Mommy Makeover patients report that they noticed an improvement in their frequency and pleasure of their sex life after the surgery.

Background:  The bodies of all women are affected by the tissue stresses that pregnancy causes. While some women have good skin elasticity and their bodies bounce right back into shape afterwards, this is more uncommon than common. Loss of breast volume and stretched out skin causes loss of a once perky breast shape to one with varying degrees of ptosis. (sagging) The tummy area develops loose skin and more lax abdominal muscles. These breast and abdominal changes combined with some weight that can not be easily lost makes for a mommy’s body that may be in need of a makeover.

Hispanic patients make up an increasing segment of American plastic surgery and women make up the vast majority of these ethnic patients. The shape of the body and a keen sense of fashion are important cultural influences in this society, even more so than in most American Caucasians. Having perky breasts, a flatter and tighter abdomen and more rounded buttocks gives the Hispanic body more curves and appeal. Thus the growing numbers of Hispanic women who undergo breast augmentation, tummy tucks, liposuction and buttock enlargement.

There are some unique aspects of any plastic surgery procedure in Hispanic patients, including the Mommy Makeover. Hispanic skin is almost always thicker with more pigment-generating cells. While their thicker skin is far less prone to wrinkling and sagging than skin of Northern Europeans and Scandinavians for example, this is really only relevant in the face. Their more mesomorph-like body types are prone to fat accumulations and their breast and abdominal skin is easily stretched out and made loose. Their skin type makes it prone to potential unsightly scarring and changes in skin tone around the incisional area.

Case Study: This 33 year-old Hispanic female wanted to improve her body after having two children. Her breasts had lost volume and had some very slight  sagging. Her abdomen had considerable  loose skin and stretch marks with a deformed belly button and muffin tops at her sides. She was at a reasonable weight of 134 lbs at 5’ 4” tall.

Under general anesthesia, her Mommy Makeover took 4 ½ hours and was done as an outpatient. While implants and a vertical (lollipop) breast lift would have given her the most uplifted breasts, I did not feel the scars in her skin type was a good aesthetic trade-off. Larger silicone implants of 400cc in size were placed through small lower breast crease incisions but with emphasis on lowering her current breast fold to create a ‘pseudolifting’ effect. Concurrently, a full tummy tuck with liposuction of the flanks (side of the waistline) and upper abdomen (side of the waistline) was done with muscle plication and the creation of a new belly button shape. The fat harvested from the abdomen was processed and then injected into the buttocks with a total of 200cc per side.

Mommy makeovers in Hispanics must factor in one important consideration, the scar burden. Scars from most body contouring procedures are hard to avoid if good results are to be obtained and there are little alternatives to the benefits of a tummy tuck. But at least the scar can be reasonably hidden. The breast is different and any scar that wanders off of the areola should be avoided if possible. This may necessitate the use of a larger implant and a smaller breast lift to help pick up some the sagging.

Case Highlights:

1) Pregnancy creates permanent changes to the breasts and abdominal area, always associated with loose and often extra skin.

2)  Mommy makeover surgery consists of differing forms of breast enhancement and abdominal/waistline tightening.

3)  Hispanic women undergoing breast and abdominal surgery pose a higher risk of more prominent scar concerns even though they need the same types of body contouring procedures. They may also benefit by concomitant buttock augmentation by fat injections.

Dr. Barry Eppley

Indianapolis, Indiana

The concept of a Mommy Makeover has become a very popular plastic surgery procedure in the past decade. While sounding like a novel procedure, it is really nothing more than combining traditional breast and abdominal reshaping procedures in a single one-time operation. When put together they change the two body parts most affected by pregnancy and the birthing process.

The trend towards more women having Mommy Makeovers done is affected by numerous factors. As more women become aware of what can be done to restore their bodies, they are wanting to embrace those changes for an improved self-image. Some do it sooner after their pregnancies than others depending upon how quickly they can lose their baby weight and how much exercise can help with some non-surgical reshaping.

Magazine articles with celebrity examples has also helped create a style trend that has popularized (and sometimes sensationalized) how to bounce back after having a baby. Many famous moms and how they look afterwards has created awareness of what is possible, although whether they have had surgery to do so often remains more mysterious. The suspicion is that many have had surgery and clearly some have. And just like those celebrity moms that are on the cover of the magazines in the checkout counter of the grocery store, average women want to also look and feel great.

A major factor that has also created the modern-day Mommy Makeover is that combined breast and abdominal procedures can be safely done together. Often taking three to five hours of surgery time, the procedure is still done as an outpatient with little reason to stay overnite for most women. Careful attention to anti-thrombolytic prophylaxis, avoiding indwelling bladder catheters, and early ambulation has led to decreased risks of DVT, PE and urinary tract infections. While one should never underestimate the at home recovery process, within four to six weeks one can return to all normal activities. Depending upon the type of abdominal reshaping procedure, this recovery period could be even less.

Embarking on a Mommy Makeover should not be done until every effort has been made on your own to change one’s body. The timing will be different, however, between the breasts and the abdomen. There are no exercises, creams or potions that are going to restore breast volume or lift up sagging breasts. One only has to wait until one has stopped breast feeding and any breast engorgement is gone. The abdomen is a different story as clearly everyone can lose some of their baby weight. But loose skin, stretch marks, misshapen belly buttons and rectus diastasi are not going to be improved by exercise, no matter how hard one tries. You are not going to exercise loose skin away. When you put these two issues together, the earliest that most women should undergo the procedure is around six months after delivery.

Dr. Barry Eppley

Indianapolis, Indiana

Pregnancy has an effect on the female’s body that is unriveled in men. Stretching of the abdominal muscles and skin and enlargement of the breasts followed by an overall deflation with delivery usually causes irreversible tissue changes. Many of these tissues pass the elastic deformation stage from which there is no snapback or return to normal tissue integrity and tightness. When the process is repeated more than once, such tissue changes become even more pronounced.

As a result, plastic surgeons have addressed these breast and abdominal changes for a long time through a variety of procedures. Breast implants combined with lifts and various forms of tummy tucks with liposuction are used to help reverse the pregnancy-induced changes. While major body improvements can be achieved, some women end up with even better body contours than before the pregnancy process began.

This combination of breast and abdominal surgeries after a woman has finished having children has become known as Mommy Makeover. This term does not necessarily describe any specific operation(s) but is a marketing concept that implies combined multiple body site surgery. Striking a nerve for pregnancy reversal, it is a concept that many women have come to embrace. More and more women are having combined breast and abdominal procedures than ever before if their finances make it possible. This can be seen in the substantial increase in the number of breast lifts/implants and tummy tucks done every year over the past decade.  Some of this increase is the increased awareness and desire to comprehensively address the post-pregnancy body, a  very effective strategy to improve a woman’s self-esteem and operative satisfaction.

When breast and abdominal reshaping procedures are done separately, they are simpler with less recovery and risk of complications. But when combined, additional considerations need to be taken. The amount of recovery is going to be more substantial. While every women is different, it may be four to six weeks until one can return to work and be back to most normal activities. It is more stressful on the body and issues of good nutrition and cessation of smoking before the procedure is crucial. Surgery is going to take longer and one might be advised to stay overnite in the surgical facility.

Operating on two body areas simultaneously also increases the overall risk of complications such as bleeding, infection and minor wound healing issues. But even more relevantly is that the risk of aesthetic concerns and the potential desire for revisional surgery is increased. While one’s body shape will definitely be improved, multiple site surgery induces many factors that make the exact final body result unpredictable. A perfect result is very difficult to achieve in a single breast or abdominal reshaping procedure, but is impossible in multiple site surgery. Most women come to accept the minor asymmetries and scars that result from a Mommy Makeover.

As Mommy Makeover surgery continues to grow in popularity and numbers of procedures performed, it is important to appreciate that it is more than just a catchy phrase. The end result can be very satisfying but it is substantial surgery that requires adequate time for recovery and awareness that revisional surgery may be needed to obtain the best result possible.  

Dr. Barry Eppley

Indianapolis, Indiana