What's a mommy makeover?
Traditionally this has been a combination of breast augmentation and or lift with a tummy tuck for women to deal with changes their body undergoes after pregnancy and nursing.
Pregnancy and nursing are the most dynamic times in a women's life. Women need to have a significant amount of body fat just to ovulate! Then the physiology of the body changes to nurture the developing fetus and then prepare for childbirth. Blood volume alone increases by 10%. After delivery, changes continue through the nursing process. When completed, breasts can show "involutional" changes with excess skin, loss of glandular tissue and lowering of the nipple and areola. The abdominal skin can be stretched and not contract, leaving a "panniculus". The rectus abdominus muscles that run on the front of the abdomen can separate and not return to normal. This leaves a gap, or a "diastasis recti" which when severe, can mimic pregnancy. Umbilical hernias can also occur.
After the childbearing duties are completed, many women feel they don't recognize their bodies anymore. I have heard " I just want my body back" many times in our office.
The good news is that there are procedures that can be performed to improve the shape and confidence of mothers.
In general, I like women to be at a stable weight and have no lactation for 6 months before considering surgery. Breast lifts combined with augmentation can deal with the excess skin and loss of volume after nursing. In the last 5 years, fat grafting of the breast has become a common adjunct to restore volume to the breast. This of course, has the added benefit of removing fat from areas that women don't like. The flanks or love handles and thighs make excellent donor sites for fat harvest. Another good site for fat transfer is the buttocks. Many women benefit from an augmentation in this area. The prolonged benefits is that if weight gain recurs, the fat grows in areas that women may feel desirable, their breasts and buttocks.
Abdominal restoration usually consists of a combination of skin removal and liposuction. Liposuction alone is rarely sufficient. Skin retraction after liposuction is inconsistent. It's like removing air from a deflated balloon, the balloon may just show more wrinkles. The rectus diastasis or muscle separation can be repaired with a "plication". This simply means sewing the muscle together.
After surgery, drains are left in place in the abdomen for up to 2 weeks. Recovery from these procedures varies depending on the amount of surgery and the amount of "muscle work". Typically most normal activities are resumed at 2 weeks but full workouts and heavy lifting may be limited for 6-12 weeks. Surgery revisions may be required especially for women who have severe "ptosis" (droopy breasts) or a lot of excess skin in the abdomen. I place most women on blood thinners after surgery. The most feared complication after a tummy tuck, is a blood clot in the legs. Although rare, if this clot breaks off, it can travel to the lung causing serious consequences including death. A once a day injection of a blood thinner for the first week of two helps take the worry out of these serious complications.
In general, mothers are some of my happiest patients. Their bodies have gone through so much change and and they have an understanding of what it takes to make them better.
If you are interested, come in to our office for a consultation and I would be pleased to develop a plan that suits your individual needs.
"Your Inland Empire Plastic Surgeon"
Duncan Miles, MD, FRCSC
