A ^Retired Plastic Surgeon's Notebook


Mommy Makeover

I prefer the term Maternal Restoration because Mommy Makeover just seems like a trip to the spa for a new hairdo, a facial and maybe, if you’re lucky, a foot massage.

As a mother to three, I can attest that bearing children is just about the most amazing thing a woman can do. Childbearing can, however, do some pretty not-so-amazing things to a woman’s body.  I’m not a psychiatrist so I won’t discuss all the amazing and not-so-amazing things children can do to their mothers’ psyche.

Mommy Makeover Quick Facts:

  • Costs: widely variable.  Low estimate:  $8000 for lower abdominal liposuction and breast lift. High estimate:  $20,000 for full abdominoplasty, breast lift and augmentation with gel implants.
  • Post-operative pain: mild to severe, depending on which procedures are done.
  • Time in post-op bra and compression garment: 3 weeks.
  • Time off work or school: 2 – 3 week.
  • Time off driving the kids to lacrosse: 1 – 2  weeks or once you are off narcotic pain meds.
  • Time off the gym: 3 – 6 weeks depending on which procedures are done.
  • Time off the slopes: 6  weeks.
  • Time off the kite board: 8 weeks.
  • Time off house work: forever! Just kidding, usually 2-6 weeks depending on which procedures are done.
  • How long  a mommy makeover lasts: long lasting unless you have another baby and/or significant weight change.
  • Patient satisfaction: very, very high.

Now for the fine print:

I’ll start with the breasts. I know it’s politically incorrect to say that childbearing and breast feeding makes the breasts deflate and/or sag. BUT I have to say that postpartum breast atrophy and/or sagging keeps me in business. It just makes sense that with the sometimes rapid and significant breast enlargement some women experience with pregnancy and lactation, sagging could result.

Restoration procedures of breasts depends on the patient’s anatomy and her wishes.  If a woman is happy with her size but not her shape, a breast lift will likely effective.  Sometimes I combine some fat transfer with breast lift to give the size just a little boost (usually about one cup size).  If a woman wants a major increase in size, I will usually recommend an implant.  Sometimes patients think they are saggy and they are just really deflated.  The breasts are flat and loose but the nipples are where they should be.  In these cases fat transfer (for a little volume restoration) or implants (for major volume restoration) is indicated.   It’s best to wait until childbearing is complete before undergoing these procedures.  Usually implants, fat transfer and/or lifting do not interfere with nursing but another baby may mean more changes in the breasts and more surgery.

It’s best to wait at least 3 months after weaning that little bundle of joy before having surgery. The breasts will have returned to their non-lactating size and hopefully the baby have forgotten about them and no longer think of them as his or her property. Having a little paw grab a recently operated breast can be pretty painful.
Now for the abdomen.  I am always amazed at how much that saggy prune belly that is so depressing those first few weeks after delivery can recover. I know lots of ladies who have a lovely belly after childbearing even if there is a little softening and rounding. I’m not sure that chiseled 6 pack look is attractive on any woman and I’m sure it looks a little odd on a lady with a toddler on each hand.

Some women are not so lucky and have major problems with laxity of the skin and the abdominal muscles after childbearing. This correlates some with the size of the baby, the amount of weight gained and the number of pregnancies. Often the abdomen recovers very nicely with the first baby but baby number two wrecks havoc.

Abdominoplasty, a.k.a. tummy tuck, can restore most women to a near pre-pregnancy shape. Abdominoplasty tightens the skin and the muscles and also removes most of the stretch marks below the navel. The trade off is a scar that can be a little longer than a C-section scar or quite long, hip to hip, depending on the degree of laxity and the patient’s anatomy. One change that cannot be addressed is the spreading of the hips and rib cage that can occur with pregnancy. The ribs can be spread out especially with a pregnancy involving twins (or more) and the pelvis can also spread in response to hormones late in pregnancy. The only thing that address these issues involves a moving bones and I do not go there and neither should any patient!

The timing of a maternal restoration can be tricky. Mothers want to look nice ASAP but recovery can be challenging when there are little ones to look after. I really like patients to care for no one but themselves for a couple of weeks after surgery and to avoid lifting anything (including children) over twenty pounds for six weeks after surgery. Family members really need to help and mothers really need to kick back and rest. Doing too much can result in a prolonged recovery and a lot more discomfort and frustration than is necessary. Just imagine how much more your family will appreciate everything you do for them after they have had to do it for themselves for a few weeks!

If you would like to schedule a consultation with a plastic surgeon and a mother of three (that would be me), please give my office a call at 206 467-1101.  And don’t worry about bringing your kids to your appointment.  We looooooove babies and little kids.