| Dr. Sam Jejurikar 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. Mommy Makeovers, or post-maternity body and breast contouring, involves a combination of surgical procedures to restore a woman’s pre-pregnancy body. Usually, this involves a tummy tuck with some form of breast surgery; depending on the patient’s needs, this could be a breast lift, breast augmentation, breast augmentation with lift, or, in some cases, a breast reduction. Liposuction of the abdomen, hips and thighs is also commonly added to the procedure.
Q. Who is a good candidate for Mommy Makeover?
A. Best candidates are women who are done having children, are in good physical health, and are reasonably close to their ideal body weight. Typical complaints include excess skin and stretch marks of the abdominal wall, overhanging skin, bulging of the upper and lower abdominal wall, excess fat of the hips, thighs and abdomen, and droopiness of the breasts with loss of the volume. Candidates should realize that mommy makeovers are surgical procedures, and, as such, must anticipate missing work for 1-2 weeks after surgery and must refrain from strenuous activity for 6 weeks after surgery.
Q. What are the important facts about the safety and risks of the Mommy Makeover?
A. Bad outcomes are very rare, but there are some risks of surgery about which all patients should be educated. Although very infrequent, it is possible to bleed excessively after Mommy Makeover surgery and require another procedure to drain the accumulated blood (hematoma). Some patients also develop a collection of watery fluid called a seroma. A seroma can serve as a significant nuisance postoperatively, and can interfere with the re-draping of the abdominal skin. Seromas are usually treated by repeated aspirations of the fluid over several weeks after surgery; sometimes, they require placement of a drain many weeks after surgery.
A significant amount of skin and fat is removed the tummy tuck portion of a mommy makeover. If the blood flow to the remaining skin is compromised, that tissue can die, leading to problems with wound healing. If a pocket of fat dies, it tends to turn into an orange-yellow fluid and drain from the incision. More significant pockets of dead fat can turn into hard lumps below the skin. Death of the skin can lead to an open wound after surgery. Usually this heals, but it can take several weeks for final healing to occur. If the scar is thick or wide after this, sometimes a secondary scar revision is required. The chances of skin or fat dying are markedly increased if patients are using tobacco products.
Infections, although rare, can occur any time in the first 4 to 6 weeks after surgery. If a breast implant were to become infected, in the worst-case scenario, removal of the implant for several months may be required.
Breast implants may break or leak. Most often, breast implant rupture is the result of normal wear and tear on the implant shell. If a saline-filled implant breaks, the implant will deflate within a few days and the body will absorb the salt water. To restore volume, another implant needs to be placed. If a break occurs in a silicone breast implant, silicone gel may move into surrounding tissue, provoking an inflammatory reaction which can lead to scar tissue formation around the implant (capsular contracture). There may be a change in the shape of the breast, and the breast may become hard and painful. This will require a second operation to remove the breast implant shell and to replace the leaking implant.
Pulmonary embolism is quite rare, but is the most feared risk after Mommy Makeover. A pulmonary embolism is a blood clot that has broken loose from the veins of the leg or thigh and travels in the bloodstream to the lungs. If a clot travels to the lungs, it can cause serious breathing problems and, in severe cases, can cause death. Pulmonary emboli usually happen within the first 2-3 days of surgery, with the most common symptoms being shortness of breath, a racing heart, and fatigue. Walking as soon as possible after surgery markedly reduces the risks of pulmonary embolism. In addition, anti-embolism compressive devices are placed on all patients during Tummy Tuck surgery, and some patients also receive injectable blood thinners. All of these treatments in combination can help keep the risk of pulmonary embolism to a minimum.
In some patients, the scars end up healing wider or thicker than expected. If this is the case, several months after surgery, a scar revision may be required to allow the incision to heal as a thin, flat and fine line.
Q. What happens during the Mommy Makeover surgery?
A. A Mommy Makeover is the combination of multiple surgical procedures. The first part is an abdominoplasty, better known as a tummy tuck. An incision is made from hipbone to hipbone close to the pubic area, and another small incision is made around the navel. The skin is separated from the abdominal muscles, which are pulled together and sutured for a firmer abdomen and narrower waist. The skin flap is stretched down and over the tightened muscles, all excess skin is removed, and the navel is reattached in a natural position.
The next part of surgery usually is some type of breast surgery. Many patients undergo some type of mastopexy, better known as a breast lift. Breast lift rejuvenates the breasts by removing extra skin and tightening supporting tissues to create a more youthful contour and shape. After a breast lift, the breasts are higher on the chest and firmer to the touch. Breast lifts also reposition and reduce the size of the areola (the dark skin surrounding the nipple), which usually have become droopy or enlarged. The incisions used for a breast lift depend on the size and droopiness of the patients’ breasts. Some patients opt to have breast augmentation with breast implants, with or without a breast lift. Breast augmentation, as part of a mommy makeover, can give women who have lost breast mass after pregnancy or breastfeeding a fuller, firmer, and better-proportioned look. Breast augmentation involves placement of silicone implants or saline implants through incisions on the breast. A few women have developed heavy, pendulous breasts after pregnancy and are better candidates for breast reduction (reduction mammaplasty). Breast reduction surgery generally takes two to four hours, depending on the patient’s breast size and the planned incisions. The size and shape of the breasts, as well as the desired amount of reduction, helps determine incisions are right for the patient.
Liposuction can play a large role in some patients’ mommy makeovers. The surgeon will make tiny incisions and inject a local anesthetic into the area to help expand and firm the fat, making it easier to remove. A long metal tube (cannula) is then inserted through the incisions to suction out the fat.
The total time for surgery depends on the specific procedures performed and the size of the patient, but generally ranges from 4 to 6 hours. All mommy makeovers are performed in an accredited surgical facility under general anesthesia.
Q. What are the Options for the Mommy Makeover?
A. Obviously, women can choose not to have surgery. Proper diet and regular exercise are the best manner in which to promote a healthy lifestyle. Unfortunately, though, diet and exercise usually aren’t enough to achieve a pre-pregnancy body. With pregnancy, most women experience irreversible changes to their body. The muscles of the abdomen usually separate, loose skin with stretch marks often develop, and the breasts can become droopy and smaller. Without surgery, patients usually cannot obtain firm, perky breasts or a taut abdomen.
Noninvasive procedures may have some merit, but cannot deliver the same level of results as surgical procedures. Radiofrequency (Thermage) can be useful in treating loose skin and cryolipolysis (Zeltiq) can be effective in promoting fat removal. Again, although these modalities have benefit, the results seen are not comparable to those seen after Mommy Makeover surgery.
Q. What is the recovery time for Mommy Makeover?
A. All people are different, and as such, every patient experiences Mommy Makeover surgery differently. That being said, certain generalizations are helpful to give patients an idea of what to expect after surgery.
Most women experience pain significant enough to require pain medication for 3-7 days after surgery. After the first few days, the pain has usually subsided enough to discontinue narcotic pain medications.
Surgeons will ask patients to walk around as much as tolerated starting the day of surgery. This helps prevent blood clots in the legs and can help restore the patient’s sense of well being. Patients are not allowed to engage in strenuous activity or exercise for six weeks after surgery, as strenuous activity can sometimes cause serious bleeding or bruising. Most patients take one to two weeks off from work.
Q. How much will the Mommy Makeover cost?
A. Costs range from $9500 to $15,000. Prices vary depending on the extensiveness of the procedure, the length of the procedure, the specific procedures performed, the price of breast implants, the costs of the surgical facility and anesthesia, and whether an overnight stay is required.
Q. How to contact Dr. Jejurikar if we have further questions?
A. For answers to your questions, do not hesitate to visit Dr. Jejurikar’s Web Site (http://www.drjdallasplasticsurgeon.com) or call his office at 214-827-2814. |
