Deciding to go under the knife or needle for any reason is, needless to say, a big decision. What’s the best way to make a big decision? Arm yourself with as much information as possible. In this series, Ask AEDIT, we break down the best questions to ask before choosing to undergo aesthetic treatments and procedures with expert insight from the providers that perform them.
Wanting your pre-baby body back — after the triumphant wave of the miracle of childbirth subsides, of course — is an extremely relatable sentiment. In fact, the American Society of Plastic Surgeons (ASPS) reports that three out of the five most performed surgical procedures for women in 2019 — breast augmentation, liposuction, and tummy tuck — make up the crux of the so-called ‘mommy makeover.’
Despite its cute moniker, it is an intensive surgery that combines multiple procedures into one fell swoop operation. So, what procedures does a mommy makeover include, specifically? Well, that depends on who you ask. “There are a ton of variations to a mommy makeover,” says David Sieber, MD, a board certified plastic and reconstructive surgeon in San Francisco. “There’s a lot going on, and it’s serious in the fact that it’s a longer procedure because they’re having so much done at once.”
One thing all providers can agree on? There is a lot of room for interpretation. “A mommy makeover is a general term to describe a constellation of procedures, but most commonly addresses the patient’s abdomen and breasts,” says Manhattan-based double board certified plastic and reconstructive surgeon, David Shafer, MD, noting that a stomach’s lingering round appearance months after childbirth is due to the separation of the abdominal muscles (diastasis recti) during pregnancy and can only be restored surgically.
If a mommy makeover is on your radar now or sometime down the road, you likely have a lot of questions. Below, we are breaking down the most important #realtalk topics to ask yourself and your surgeon — from aligning on specific goals to the surgical and recovery plans, and everything in between.
1. Ask yourself: Do I know what a mommy makeover actually is?
Before you can know if it’s the surgery you want, you need all the deets first. “For me, a mommy makeover usually consists of liposuction — most commonly the abdomen and flanks — the tummy tuck, and then some sort of breast surgery, which could mean augmentation or just a lift,” Dr. Sieber explains. The breast procedure could be a breast lift, breast augmentation, fat transfer, breast reduction, or some combination. “Basically, the breast surgery, whatever it is, restores loss of volume after having children and/or removing extra skin as a result of breastfeeding,” he says.
And then there are add-on procedures that are a little less common but can still be thrown into the mommy makeover mix. Those include vaginal rejuvenation, labiaplasty, or even just additional areas for liposuction (think: the thighs or arms) and are all “pretty easy to add on at the same time,” Dr. Sieber shares.
2. Ask yourself: What are my ultimate goals?
Your body goals and what you’d like your figure to resemble post-op after everything settles will determine your surgical plan. “The procedures depend on the patient’s anatomy and desired results,” Dr. Shafer explains.
Take the breasts, for example. “If a patient has small breasts, an A or B cup, then often breast implants are enough to improve the shape, size, and give a slight lift,” he says. But, if the breasts are drooping, “then a lift would be necessary.” For a patient seeking “larger and lifted breasts,” meanwhile, “a breast lift and implants are performed,” he adds. During your consultation, be sure to share your ideal outcomes and then ask what results are reasonable for your body and lifestyle.
3. Ask your doctor: I had a C-section. Can I still get a mommy makeover?
In a word: Absolutely. “A c-section scar is often a reason why patients want a tummy tuck,” Dr. Shafer says. “The c-section scar creates a point of adherence to the underlying tissue, which often leads to a shelf of loose tissue hanging over the skin.” One of the main reasons for this? No skin is removed during the c-section, so it leaves the stretched skin to sag. “When I perform a tummy tuck or an abdominoplasty, I remove the c-section scar and work to make the incision at or below the level of the c-section incision,” Dr. Shafer notes.
4. Ask yourself: How much time do I have for recovery?
Dr. Sieber does not mince words when it comes to getting real about recovering from a mommy makeover: “You’re going to be very, very uncomfortable.” Both surgeons say that recovery varies from person to person and is influenced by their age and overall health, but all patients should expect antibiotics and narcotics to ensure that the pain — especially the first few days post-surgery — is tolerable. Dr. Sieber adds that patients “definitely need to plan for a mommy makeover” and will need a 24/7 support person. That person can be a partner, sibling, friend, or professional caretaker for the first two to three days post-surgery because “you really need to have someone there who can help take care of you.”
Dr. Shafer has his patients wear compression garments for six to eight weeks and tells them to hold off on lifting children or heavy items for about six weeks as well in order to avoid engaging the core abdominal muscles while they’re healing. “Most of the swelling and bruising will resolve in the first few weeks,” he says. “Patients will start to feel like themselves again and get back to work and their regular activities, but still need to do incision care and dressing changes.” In the months following the surgery, Dr. Shafer recommends lasers and other in-office technologies for incision treatment and scar reduction.
While swelling subsides over the first few months, the sutures Dr. Sieber uses for a mommy makeover last up to six months before dissolving. “So, even though patients are feeling a little better, if they turn a certain way and feel a tug from the suture, they get zingers from the nerves,” he explains. “There are a lot of little annoying things that will randomly happen three to six months after surgery.”
5. Ask yourself: Am I planning to have more children?
If you are looking to maximize your experience under the knife, a mommy makeover surgery is the most time-, cost-, and recovery-effective for women who have no plans for future children, according to Dr. Sieber. Needless to say, surprises happen, so rest assured that a future pregnancy wouldn’t disqualify you as a candidate for a mommy makeover — it would just reverse the results as the abdomen re-expands and body changes.
6. Ask yourself: Am I still breastfeeding?
“The usual rule of thumb is you want to be done breastfeeding for six months before doing any type of breast surgery,” Dr. Sieber shares. As he explains, you want all the milk glands to be done producing milk because, if you perform a breast surgery when the patient is still lactating, you could get milk in the wound. That “increases the risk of getting a bacterial contamination or other infections,” he cautions. If you’re super eager to get your pre-baby body back, a mommy makeover can be performed six to eight weeks after discontinuing breastfeeding, Dr. Shafer says.
7. Ask your doctor: Should I do all the procedures I want at once?
Since a mommy makeover combines several procedures, it is generally one of the more time-consuming aesthetic surgeries. In fact, Dr. Sieber reserves his entire day when a mommy makeover is scheduled because they can take upwards of five hours.
After he aligns with patients on the intense recovery, time in the OR is the next hurdle. “The question to ask is how long it’s going to take the surgeon to complete the procedure,” he explains. “Mommy makeovers can vary a lot, so it can be anywhere from four to seven hours.” Generally speaking, surgeons will only perform the procedures they know they can fit into a six-hour period to minimize risk. “One thing you definitely don’t want is a surgery longer than six or seven hours because the risk of complications gets higher,” Dr. Sieber cautions.
As a result, one surgery for several complicated procedures sometimes isn’t worth the gamble. Dr. Shafer says that it’s “not uncommon to stagger the procedures.” In such cases, a breast surgery may be performed first and then followed by the abdomen procedure six to 12 weeks later. Safety is, obviously, the number one priority and working with a board certified provider who specializes in mommy makeover surgeries will help to ensure you receive the best treatment for your needs.
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