Blog — Notes of a Plastic Surgeon

Welcome to my blog. I am a plastic surgeon in Seattle and have been in private practice since 1991. I've seen more than a few interesting faces and cases through my years spent in the exam room, the operating room and the emergency room. And I have an opinion on just about everything relating to plastic surgery (and a lot of unrelated stuff). If you like my blog, let me know. Thanks for reading! Lisa

Category: Mommy Makeover

Will there be plastic surgery under your Christmas tree?

November 30th, 2018 — 3:11pm

Seattle plastic surgeon encourage the gift of plastic surgery.How to give the gift of plastic surgery.

Looking for the perfect gift this holiday season?  That perfect gift may just be a plastic surgical procedure.  Here are a few tips if you are considering this most thoughtful and personal of presents.

  • Only consider this if your loved one has confided in you that he/she is considering “doing something” or that he/she just wishes that he/she could just “get rid of this ______(fill in the blank)”.  Remember, it’s about him/her, not about you.
  • Make sure the lucky recipient is a good candidate for surgery.  Good candidates for surgery are in good heath (physically and mentally) and are in a socially stable place in their life.   If in doubt, shoot me an email and I can probably make an educated guess.  Do not, I repeat, do not give the gift of liposuction as a substitute for weight loss.  Need convincing that doing so is a bad idea?  Check out my blogs on obesity.
  • Make sure that you can afford the surgery!  You wouldn’t want to have to back out because of sticker shock.  I have a lot of ball park prices posted on my web site.  Or feel free to shoot me an email and I can give you a financial idea of how much this could set you back.
  • Make sure that lucky guy/gal will be able to take enough time off of work and/or household duties to recover.  It’s misery to try to get back to work too soon.  You want your gift to be a positive experience.  I have recovery times listed for most procedures on my web site.  Or shoot me an email.
  • Make sure you have nice package to present.   You can’t wrap up a tummy tuck or eyelid lift, but you can wrap up something they might love to wear or use after all the discomfort and bruising is gone.  Maybe something sassy from Hanky Panky for that mommy makeover patient or a pair of beautiful Firefly earrings for that eyelid lift patient.  Or for that dude of yours, how about a nice pair of Ethica boxer briefs You can include one of my practice brochures and a procedure brochure.  Oh, I can just hear the shrieks of joy now!

And just think, your gift of plastic surgery will last years, even decades.  You and your loved one will be enjoying the benefits much longer than a new car or television or laptop.  Do the math.  It could end up being a great value as well as a great gift!


I would be honored if you followed me on Instagram @sowdermd and @breastimplantsanity.

Mommy Makeover, Now That's Cool, Plastic Surgery, Postoperative Care

Nipple reduction and a breast lift can make the breasts look fuller.

September 27th, 2017 — 11:55am

Check out this case.

This lady initially came in for breast augmentation.  She wanted to look a little fuller but was a worried about the impact of larger breasts on her competitive tennis game.  After chatting with her and examining her, I came up with the plan of a lift and a nipple reduction.  These procedures would give the illusion of fuller breasts without actually increasing the volume.

A small and saggy breast with a long stretched-out nipple looks – I’m gonna say it – a little pathetic.  Once the breast skin is tightened up and the nipple shortened, the breast looks almost the way it did before babies, breast feeding, gravity, general aging, etc.  And a procedure like this is maintenance free.  It should last a lifetime.  But remember to wear a bra most of the time when upright.  Gravity never sleeps.

Thanks for reading!  Dr. Lisa Lynn Sowder

Follow me on Instagram @sowdermd and @breastimplantsanity.

Breast Contouring, Breast Lift, Mommy Makeover, Nipples

Plastic Surgery FAQ: I’m a total wreck. Where should I start?

June 14th, 2017 — 4:16pm

Seattle Plastic Surgeon answers Plastic Surgery FAQ:  I’m a total wreck.  Where should I start?

faq total wreckI often see patients who are interested in several different procedures.  They have a laundry list of things they would like to change.  A recent example was a middle aged lady who wanted hip liposuction, a face lift, a tummy tuck, a breast lift and an otoplasty to pin back her protruding ears.  Geeze, it would be unsafe and impractical to do all of those procedures in one mega 12 hour case.  It would be unsafe because that is a long, long time to be under anesthesia, multiple areas of the body would need to be exposed and that increases the risk of hypothermia, although any one operation has very little blood loss, all those procedures combined could significantly lower her blood count, and she would be sore from head to toe making her post operative recovery miserable.  It would be impractical because I really can’t stay at my best in the OR for 12 straight hours.  I just can’t.  And my nurses and techs and anesthesiologists don’t want to work a 12 hour case and we would finish the case well after dinner time.

My advice to this patient is to start with the area that bothers her the most.  In her case, it was her abdomen.  So we made the decision to do her hip liposuction and her breast lift at the same time as her abdomen.  By grouping these procedures, she saves some money and it saves her a lot of recovery time.   And – this is really important- I won’t be fatigued when I am putting in those last few stitches and the anesthesiologist will still be awake!

So if you are contemplating several procedures, try to decide which procedure you want the very most.  We can usually group procedures and still keep it safe and practical.

Oh, one more thing.  Sometimes the place to start is not the operating room.  It may be smoking cessation, getting into better shape or even a serious medical skin care program.  Sometimes surgery is the last stop on the line to improving appearance.

Thanks for reading! Dr. Lisa Lynn Sowder

If you think you are a total wreck and don’t know where to start, give my office a call to schedule a consultation, (206) 467-1101.

I would be honored if you followed me on Instagram @sowdermd and @breastimplantsantity. See you there!

Mommy Makeover, Patient Safety, Plastic Surgery, Surgical Eductaion


May 14th, 2017 — 7:00pm

motherhoodSeattle Plastic Surgeon Discusses Mommy Makeover on Mother’s Day

Ah, the joys of motherhood! I can wax eloquently about fat little feet, apple cheeks, wet baby kisses and so on but one of the joys I did not expect was a boost in my Plastic Surgery practice, especially my “mommy makeover” patients. Since becoming a mother myself, I speak “mommy” really well. I know first hand the glorious details of feeding, bathing, changing, and schlepping the baby. I can recite the stages of the toddler, the preschooler, the gradeschooler, the tween, the teenager and currently I am becoming an expert on the joys of being the mother of young adults.  

Being familiar with all that being a mother requires makes me much better at counseling patients about the process and timing of a “mommy makeover”.

“Mommy makeovers” usually combine breast surgery (augmentation and/or lift or reduction) with body surgery (usually abdominoplasty and/or liposuction). Most women are healthy enough to have a combination of procedures during one operative session. It is, however, the first couple of post operative weeks that are the most challenging for the patient.

Mommy is used to taking care of everyone but herself. After surgery the Mommy needs to take of only herself. She needs to be “Queen for a Week or Two” and resist the urge to cook, clean, change, wipe, mop, vacuum, load, unload, fold, etc. And if her youngest weighs over 20 pounds, she may not pick him/her up for at least two weeks if breast surgery was done and for at least six weeks if an abdominoplasty was done. The little one can crawl into Mommy’s lap for a cuddle but NO HEAVY LIFTING for Mommy. This also applies to the dog.

It’s very important to for patients to discuss these issues with their families. I’ve had a few ladies who have underestimated their recovery time, have done too much too soon and have turned what should be a relatively comfortable and relaxing recovery into a very sore and frustrating one.

So, calling all mothers interested in a “mommy makeover”: Plan ahead and get your husband and your children and your friends on board. Make a sign for your bedroom door. “DO NOT DISTURB – MOMMY RECOVERING”.

Body Contouring, Breast Contouring, Breast Implants, Breast Lift, Breast Reduction, Mommy Makeover, Plastic Surgery

Are the planets aligned for your surgery?

January 16th, 2015 — 1:12pm

Is there an astrologer in the house?

blog planets alligned

How are those planet lining up for your day of surgery?

Today I saw a lovely lady who is a great candidate for tummy tuck and fat transfer to the breasts.   She’s done with babies, her youngest is out of diapers and she is ready to reclaim a little bit of her babehood.  She’s also got some help lined up and some time off work available and now all she needs to do is check with her astrologer to make sure planetary alignment is just right!

Back when I was a smarty pants young surgeon, I would have dissed this lady’s belief in astrology but now that I have been around the block a time or two, I recognize that many people believe in things that I don’t and vice versa.  So if I need to tweek my schedule a little bit to get in alignment with her planets, I’ll do my best to do so.

Thanks for reading and by the way, I’m an Aries.  That explains everything, huh?  Dr. Lisa Lynn Sowder

Mommy Makeover, Now That's a Little Weird

Progressive Tension Sutures in Tummy Tuck – well worth the extra 15 minutes

May 20th, 2014 — 8:10pm
Progressive tension sutures secure the abdominal fat pad to the muscle.

Progressive tension sutures secure the abdominal fat pad to the muscle.

Seattle Plastic Surgeon explains why she uses progressive tension sutures in her tummy tuck patients.

I saw a patient today for a tummy tuck consultation.  She had spent quite a bit of time researching tummy tucks on the Internet and had a lot of questions about my technique.  I went down her list of questions with her and answered them as best I could.  Her last question, “do you use progressive tension sutures?”, was the first time I have had a patient ask me about that particular part of the procedure.  My answer was a resounding YES!!!

Progressive tension sutures are also called quilting sutures or mattress sutures.  These stitches secure the underside of the abdominal fat pad to the abdominal muscle layer.  They serve several purposes.  They take tension off the incision line which can result in more favorable healing and scarring.  They close off the potential space between the abdominal fat pad and the muscle and help prevent fluid (a seroma) from accumulating.  Drains can come out much sooner:  after 2 – 4 days instead of after 7 – 10 days.  These stitches also help the patient remember not to twist or turn in the first weeks after a tummy tuck because those actions will cause a little twinge.

I have been using progressive tension suture ever since I attended an instructional course in this topic taught by Drs. Harlan and  Todd  Pollock.  My rate of post-operative fluid collections (seroma) went from about 25%  to (honest to God)  ZERO.   This addition to my abdominopasty adds about 15 minutes of operating time but has reduced the time and hassle of draining seromas after surgery.   It’s a good investment in my time.  Every time I see either Dr.  Pollock at a medical meeting, I thank him for introducing me to this very, very useful technique.

Thanks for reading!  Dr. Lisa Lynn Sowder


Body Contouring, Mommy Makeover, Tummy Tuck

Mother’s Day is almost here.

May 7th, 2014 — 3:59pm

Seattle Plastic Surgeon and mother of three teenagers (!) has a gift suggestion for Mother’s Day.  She hopes her husband and children read this blog.

This robe is as soft as a kitten.

This robe is as soft as a kitten.

I recently  had to spend the better part of a day at SeaTac, Seattle’s airport, while waiting for my delayed flight to San Franscisco to attend the annual meeting of the American Society for Aesthetic Plastic Surgery.   Fortunately, SeaTac has a really nice terminal with lots of shops and restaurants to while away the hours and whittle away your wallet while waiting.  I happened upon this wonderful robe at a gift shop called Fireworks Gallery.  It is as light and soft and cuddly as a kitten.  I almost expected it to start purring.  This robe is at the top of my list for this Mother’s Day.

If you are interested in this robe for a wonderful mom in your life, Seattle has several Firework Galleries and it’s also available online from the manufacturer’s website :   And if the mother on your list already has a nice collections of robes, Tourance also carries a Wild Hyena Faux Fur Throw with Chocolate Rosebuds.  Sounds fun, huh?

Happy Mother’s day to all.   I’m looking forward to breakfast in bed this Sunday.  Thanks for reading!  Dr. Lisa Lynn Sowder


It's All About Me., Mommy Makeover, Stuff I love, Wardrobe Observations

Mons pubis reduction: Yes, it is a procedure I perform.

April 24th, 2014 — 8:51am

Seattle Plastic Surgeon blogs about the saggy and/or fatty mons pubis.

blog monsI get a lot of email inquiries about the mons pubis.  This is a problem area for many women and there just is not a lot of information out there about treatment options.  So, here’s some info about that mons pubis a.k.a. the Mound of Venus (I just loooove that term).

The mons pubis tends to sag with gravity like everything else and like most structures, the larger it is the more gravity works on it and the more it sags.  Weight fluctuations, which are not good for the skin, can result in severe sagging.  Also, some people just have lousy skin tone.  And some ladies just have a lot of fat in the mons, even if they are quite slender.  Why, why, why?  I don’t know but I do know how to make it better.

The mons pubis should always be evaluated in the tummy tuck patient.  Lifting and/or reducing the size of the mons should be an integral part of the tummy tuck procedure in patients who have issues.  Addressing the mons pubis adds very little time to the tummy tuck procedure and does not make for a longer recovery.  Not addressing a heavy and/or saggy mons at the time of tummy tuck can result in an imbalance between the abdomen and the mons pubis and can look really, really odd.

Mons lift and/or reduction can be done separately from a tummy tuck in patients who have already had a tummy tuck or in the occasional patient who has a heavy mons pubis despite a trim abdomen.  If she has great skin tone, liposuction is often very effective.  If the skin tone is not so good, liposuction plus skin tightening is done.  This latter procedure leaves a scar much like a C-section scar.  Because it is difficult to keep this area of the body elevated after surgery, post-operative swelling can last awhile but usually after a few weeks, the difference is very obvious and at three months, most ladies are thrilled with their trimmer public area.

Oh, one other thing:  This type of surgery does not effect genital sensation at all.  The nerves to the real lady bits do not travel through this area.  The actual mons might be a little numb for a few weeks or months but that has not been an issue with my mons pubis surgery patients.

Thanks for reading!   I hope I didn’t make you blush.  Dr. Lisa Lynn Sowder

Body Contouring, Mommy Makeover, Tummy Tuck

Mommy Makeover – my very favorite postoperative question.

April 1st, 2014 — 2:00pm

Seattle Plastic Surgeon’s favorite mommy makeover postoperative question:  “Is it okay for me to wear a bikini?”

Be sure to wear your sunscreen!

Be sure to wear your sunscreen!

I saw one of my favorite patients yesterday.  She’s a hard working mother of three and is about a year out from her mommy makeover.  She wondered if was okay for her to wear a bikini on an  upcoming adult-only-no-kids-invited trip to Maui.  And to think that just a year ago, she was loath to get into any swimsuit.

This is what my makes my work so enjoyable.  It’s gratifying to see these moms (and sometimes grandmoms!) get a little or sometimes a lot of their babehood back.

Recovering from a mommy makeover can be a challenge in many ways.  There is the discomfort, the physical restrictions, the time off work, the extra needed help with the kids, and those darn scars but ……………….once the patient is back to her normal routine and the scars are on their way to fading, she can slip into a bikini, run into the surf and enjoy many more years of being a babe.

Thanks for reading!  Dr. Lisa Lynn Sowder


Mommy Makeover

Woman inherits her mother’s plastic surgery fund.

November 8th, 2012 — 12:31pm

Seattle Plastic Surgeon discusses a very thoughtful mother’s last wishes.

“To my daughter, I leave $$$$$ for the purpose of plastic surgery.”

One question I always ask when a patient is thinking about having a plastic surgery procedure is “why now?”    The answer can be very interesting and often very relavent.  Here are some answers I have received over the years:

  • I’ve always wanted to do this but my husband wouldn’t let me and now we have split up and I can do what I want.
  • I’m old enough to make my own decisions now.
  • I saw a photo of myself at my son’s graduation and was shocked when I saw my double chin.  I didn’t think it was that bad.
  • I flipped a house in Ellensburg and have the money.  (This was, of course, before the real estate crash.)
  • I finally have my kids through school and can spend the money on me instead of them.
  • I’ve worked so hard to get down to and stay at this weight and now I want to do this as a reward.

Recently I received an totally unexpected answer to this question.  My prospective patient had recently lost her  mother after a long illness.  In the last few days, the mother confided in her daughter that she had put aside some money for a face lift.  The mother was a fan of plastic surgery having benefited from a breast reduction years earlier.  She wanted to make sure her daughter used this money for plastic surgery, specifically a mommy makeover.  That mother knew that everytime her daughter slipped into her swimsuit and enjoyed her surgical result, there would be a smile and a “Thanks Mom”.

Thank you for reading!  Dr. Lisa Lynn Sowder

Body Contouring, Breast Contouring, Financial Issues, Mommy Makeover

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