| Dr. Paul Angelchik is a plastic surgeon certified by the American Board of Plastic Surgery. Here the Doctor has answered some of the common questions Bizymoms visitors have about Mommy Makeover.
Q. What is a Mommy Makeover?
A. A "Mommy Makeover" is a combination procedure that generally includes a tummy tuck (abdominoplasty) and breast enhancement. Usually the breast enhancement incorporates a breast lift ( mastopexy) and often a breast implant ( breast augmentation) to lift and enlarge the breasts. Many women lose volume in the breasts with pregnancy and develop sagging and loose skin as well. The breast surgery is designed to tighten the breast envelope and restore lost volume. At the same time the tummy tuck removes loose skin and stretchmarks, tightens the abdominal wall muscles, and contours subcutaneous fat. One procedure I really like for the right patient is the lipoabdominoplasty as described by Saldanha which allows for a great combination tummy tuck and liposuction procedure on the trunk with less risk, easier recovery, and better shaping than a conventional tummy tuck.
Q. What are the risks and complications associated with a mommy makeover?
A. The risk of serious complications after a mommy makeover is low in the appropriately selected patient operated on by a well trained, experienced surgeon who is certified by the American Board of Plastic Surgery. However, plastic surgery is real surgery and there are risks that every patient must be aware of and accept prior to undergoing any procedure, no matter how simple or complex. While the list of possible complications may seem lengthy it is rare that a patient has multiple problems.
The most common issues after plastic surgery are minor issues that require a touch up. These could include the need to tighten skin which has not held its position after a breast lift, an adjustment of breast implant position, or removing a "dogear"(a small extra piece of skin) at the end of a tummy tuck incision. A seroma or collection of clear fluid in abdominoplasty patients is not rare occurring in up to 25-30% of patients after conventional tummy tucks. Fortunately this is usually resolved by removing the fluid in the office in almost all patients.
Longer term issues with breast implants can include implant leakage and capsular contracture,and permanent numbness in the breast in some patients.
More serious issues include skin loss or delayed healing, infection, bleeding, or blood clots. Blood clots, also known as venous thromboembolism, is of particular concern in tummy tuck patients. Prophylaxis against blood clots is a critical safety issue which your surgeon should take very seriously. Use of sequential compression devices, blood thinners, and early ambulation are important in reducing the risk of blood clots. Other factors such as smoking, estrogen containing medications, obesity, age, and a family history of clotting abnormalities must also be considered prior to surgery.
For a more detailed discussion of this topic, it is best to consult a surgeon certified by the American Board of Plastic Surgery (ABPS). All members of the American Society of Plastic Surgeons are ABPS certified, have at least 6 years of surgical training prior to practice, and have extensive requirements for continuing medical education.
Q. What’s behind the recent trend of "mommy makeovers"?
A. In today’s society, everybody wants to be at their best all the time. Many women feel that the process of childbearing, although wonderful in its own right, has a negative impact on their appearance and body image. Mommy makeover patients commonly tell me, "I want my body back." With modern plastic surgery techniques we can give a woman back her positive body image so that she can look as good or sometimes better than she did before she had kids and when that result is achieved, it is very satisfying for our patients.
Q. When is a good time to have a Mommy Makeover?
A. A mommy makeover should be performed after a woman has finished having children, as additional pregnancies will only cause a renewed stretching of the surgically tightened and lifted tissues. Generally allowing for 6 months or more after delivery or the end of breast feeding is appropriate. Mothers naturally want to bond with their newborn and cosmetic surgery should not interfere with this process. In reality the normal demands of having young children usually result in most women seeking a makeover when their youngsters are out of infancy.
Q. How hard is recovery from a mommy makeover?
A. Recovery from a mommy makeover is moderately uncomfortable for most patients. Modern pain control techniques including the use of local anesthetic pain pumps (a drip irrigation system providing pain relief to the operated area) and the right combination of medications make a big difference in making recovery as comfortable as possible. By allowing the patient more mobility after surgery, enhanced pain control facilitates early movement which both makes the procedure less risky in terms of blood clots and results in less stiffness and a more rapid return to daily activities. Most of the discomfort after a mommy makeover is muscle tightness and a sore sensation. Muscle relaxants are very helpful in controlling this type of problem and are routinely prescribed.
Q. Is it safe to have more than one plastic surgery procedure at one time?
A. It is safe for many patients to combine surgical procedures if they are in excellent health, with no serious medical conditions. The type of procedures, age of the patient, and surgeon preference will also determine the amount of surgery to be done. Many patients want to do as much as possible at one time, but this is not always the wisest course. Longer surgery is safer than it used to be and my experience along with the plastic surgery literature confirms this fact. Still, there is more risk with very long operations than with a shorter procedure. One other thing many patients fail to consider is surgeon fatigue. Is your surgeon as detail oriented after 8 hours in the operating room as he is at the beginning of the procedure? Thus,for most of my combination procedures, particularly in the body contouring category, I prefer to limit the surgery time to 6 hours in the appropriately selected patient. Additionally there are certain combinations of procedures like abdominoplasty with inner thigh lift that I don’t like to do because it is a particularly difficult recovery in terms of activity limitations for the first couple of weeks.
Q. I might still have more children. Should I have a Mommy Makeover?
A. No. You should wait until you are done having children as a future pregnancy can only adversely affect the results of your makeover, causing recurrent laxity and stretching of tissues. In that case you will need a Mommy Makeover Makeover.
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