“Mommy Makeover,” is a great descriptive phrase which includes a group of procedures to address changes in the breast and abdomen following pregnancy. Further, the Mommy Makeover may also include enhancements in those areas beyond what existed prior to pregnancy. As always in plastic surgery, the exact operations are tailored to the patient’s individual needs.
Debate remains on whether breast feeding worsens breast sagging or not. Regardless, pregnancy leads to significant changes in the breast. During pregnancy, the glandular tissue enlarges, stretching the skin out. Afterward, the glandular tissue shrinks and may decrease to a level far below what existed before pregnancy. The end result can be a droopy, deflated, breast.
Changes to the abdomen with pregnancy are, of course, the most dramatic. Pregnancy stretches the skin significantly as well as the underlying muscles. The two muscles which run vertically down the central abdomen expand and separate apart to make room for the enlarging uterus. After delivery, those muscles have a tendency to remain somewhat separated resulting in loss of a flat contour and sometimes a persistent bulge.
The Mommy Makeover most commonly consists of a breast procedure (lift or augmentation) combined with a tummy tuck. It is important to recognize the differences between breast lift procedures and breast augmentation procedures. Lift procedures are designed to address shape changes in the breast. Augmentation procedures include placement of an implant to change breast size. The two procedures may be used independently or in combination. Placing an implant alone will not usually correct breast drooping, it just makes a bigger, droopy breast. Likewise, a lift procedure works best if there is enough natural breast tissue to be repositioned and molded into a desirable shape. How do you decide which operation to have? The choice is best made in concert with your plastic surgeon. The surgeon will evaluate the position of the nipple relative to the fold at the bottom of the breast, measure the dimensions of the breast, and determine the relative thickness of the tissues as a guide. Most importantly, the goals you are trying to achieve in terms of shape and fullness are paramount.
All breast lift operations involve a trade of scar for shape. The scar can be as minimal as a line that runs around the border of the areola. In other cases, a vertical scar running between the areola and the fold, and possibly an incision along the fold is necessary. Adding an implant along with the lift procedure can occasionally minimize the necessary incisions.
Our version of the tummy tuck, the iTuck®, provides all the benefits of the traditional operation, does not require drains, and includes enhanced post-operative pain control. The foundation of the iTuck® procedure is repair of the separated abdominal muscles, returning them to their pre-pregnancy configuration. Significant amounts of extra skin are removed along with the stretch marks in those areas. Lastly, contouring of the hip and flank area via liposuction is a standard part of the procedure. More about the iTuck® procedure, and the breast procedures, may be found on our website www.kirnplasticsurgery.com.
In nearly all circumstances, the Mommy Makeover procedures are completed in a single trip to the operating room. Most commonly, the patient will go home the same day with no hospital stay. Recovery time is one to two weeks for most patients. We usually advise patients to allow six months or so following pregnancy before seeking this kind of surgery. If pregnancy has resulted in body changes which have failed to respond to time, diet, and exercise, a Mommy Makeover may be the answer.