| Dr. Lauren Greenberg 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. The answer varies as much as my patients vary. In general the two areas most affected by pregnancy are breast and body.
The breast tends to lose volume and droop with pregnancy and breast feeding. What you do to fix it depends on where you started. For small breasted women who do not droop, the fix is with a breast implant, a breast augmentation surgery. This can be done subtly and naturally. As for the size, incision, gel or saline implant, and profile of implant- these are decisions you make with your doctor. I strongly recommend meeting a few doctors. Look at their photos. Every doctor has an aesthetic, and you want yours to match. This is a popular surgery in general, and for me is the number one surgery I do. For women who started out with more breast tissue, pregnancy and breastfeeding tends to leave them droopy. A breast lift (mastopexy) and breast reduction are similar surgeries- the difference is whether you remove tissue as you lift. All reductions involve lifting the breast. Again, these are popular surgeries for me. With breast reductions and lifts there are two basic kinds of scar- a short scar "lollipop" and a longer "anchor" scar. I do the short scar technique, also referred to as a vertical breast lift and reduction. I recommend you find someone who does this technique.
So the most common breast surgeries are breast augmentation, breast lift, and breast reduction. The most common abdominal and body surgeries are liposuction, tummy tuck (abdominoplasty), and mini tummy tuck. I commonly combine these surgeries, which is safe for many patients.
When you have children your abdomen and thighs change with three factors: fat, loose skin, and separation of the muscles called "diastasis." If you have good skin tone but excess fat (I know, I know. Shouldn’t have eaten that cheesecake while breastfeeding), then liposuction is a good choice. It is great to sculpt and remove problem areas. Everyone does tumnescent technique. I use ultrasonic liposuction. Laser and ultrasonic are similar in breaking up fibrous fat. I tend to treat your whole body, not just your "outer thigh" or "love handle". If you don’t treat an area, when you gain weight in the future it will go to that area first, and create a funny body shape or new problem area. I have board certified MD anesthesia giving anesthesia. Safety is first.
Watch out for who is doing your liposuction. The laser liposuction companies specifically try to sell machines to nonsurgeons (because there aren’t many of us Board Certified real plastic surgeons). True Board Certified plastic surgeons train as general surgeons first. We do at least three years of general surgery, so we take out gallbladders, do bowel surgery, perform mastectomies. Why is that important? Because when you do liposuction, it is blind. I can feel where I am, I can see the layers in my mind. It makes me a better, safer surgeon. Also other specialty doctors cannot perform tummy tucks and other surgeries. They can only do liposuction. So everyone will get liposuction, whether or not the patient was a better candidate for a different procedure like a tummy tuck. Liposuction on inappropriate patients leaves them uneven, wrinkled, and unhappy- and it is something I cannot fix later.
Tummy tucks ("abdominoplasty") are a two layer repair. The first layer tightens your abdominal muscles again. When you are pregnant, your muscles separate. This is a diastasis. You cannot fix this with sit ups and core training. Every woman has a different degree of separation. When I fix this separation, I use two layers of permanent, strong suture. The second layer of a tummy tuck is to tighten the skin. This is the scar you see, and usually involves removing most of the skin between your pubic area and belly button. Your actual belly button does not move during a tummy tuck- everything around it does. A mini tummy tuck is usually tightening of the lower abdomen skin only.
Q. Who is a good candidate for Mommy Makeover?
A. Anyone with changes after pregnancy who is bothered by what they see. I like my patients to come in when they are done having children and given their bodies time to bounce back. Many changes following pregnancy improve with plain old time. So I encourage women to get into shape, eat well, exercise, get back to their prepregnancy weight, and see what their body does. I tend to see women about 2-3 years after their last child. It is at this point you can tell what is not going to change.
There are things you can improve on your own. There are things you cannot. Sheer will and exercise cannot make your breast fuller again, lift your breast, repair stretch marks or drooping skin, or fix your diastasis (the separation of your belly muscles which occurs during pregnancy).
Q. What are the important facts about the safety and risks of the Mommy Makeover?
A. As for safety, all my patients are moms. This is elective surgery. As much as you may hate your muffin top, cosmetic surgery must have a higher bar for safety. The husbands know it- you can see the please-don’t-leave-me-alone-with-these-kids look in their eyes when we go back into surgery. I always screen my patients prior to surgery. You should see your general doctor and get a good check up prior to surgery. All breast surgery in patients over 35 should have a baseline mammogram. I always have a board certified Anesthesia MD giving anesthesia. It is safe to combine procedures for appropriate patients. There is no general rule- if I am doing a tummy tuck on a thin woman it is a different surgery than a tummy tuck on someone larger. Breast augmentations have less changes and blood loss than breast reductions. A lot is common sense.
Q. What is the recovery time for Mommy Makeover?
A. Recovery for a single surgery versus a combined surgery is not that different. Usually the first few days you need to be on mommy vacation (ie no kids/meals/laundry/carpooling/diaper changing/etc etc etc). For larger surgeries, I will have them stay overnight in the hospital. The first week you will spend at home, no driving, no heavy activity. Somewhere between 1-2 weeks you will be off your pain medication and up and about again, doing your normal daily life routine. Usually you are back to presurgery activity, including exercise, around a month out. Again, every patient is different. There are different scales of surgery. Every doctor has different recommendations. Of all the surgeries for mommy makeover, tummy tucks are usually the longest and hardest recovery.
Q. How much will the Mommy Makeover cost?
A. Cost varies widely depending on what you need.
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