“Mommy makeover” usually refers to procedures that combine breast reshaping and body contouring.

Society places a premium on appearance and youthfulness and pregnancy may alter a woman’s body.  Many women feel that child bearing has changed their body and want to return to their previous look. Others want to go back to work feeling confident about their physical appearance and shape. Even though dieting and exercise may improve most mothers, some may be left with changes, such as, loss of upper breast fullness or form, loose abdominal skin, and stretch marks. These are changes that can be usually improved only with surgery. Procedures that address many of these concerns at one time are often referred to as “mommy makover” surgery.

“Mommy makeover” usually refers to procedures that combine breast reshaping and body contouring. Breast are reshaped by making them larger and lifting them or, on other occasions, by making them smaller. Body contouring procedures will depend on the amount of skin flaccidity, stretch marks, the loss of abdominal wall tone, and on the localized areas of fatty accumulation that remain despite weight loss and exercise. These can consist of skin removal such as a tummy tuck or abdominoplasty, liposuction or a combination of both.  If women are healthy, procedures that address these concerns can safely be done simultaneously allowing for just one recovery period.

The Breasts

Aging, pregnancy, breast-feeding and large fluctuations in weight will cause the breast skin to stretch and eventually cause the breasts to lose shape. This may in time lead the nipple to lie lower than the breast crease or inframammary crease. The initial stages of breast descent or ptosis will respond to breast augmentation or breast implant placement only. However as the nipple position falls below the crease level and as the skin becomes more stretched and less elastic there is a greater need to redrape the skin envelope over the breast. Depending on the severity of the droopiness and the skin stretch, we will have options in the scars necessary to do the breast lift.

When the descent or breast ptosis is minimal, a simple donut type excision, or donut mastopexy, of skin around the nipple and areola suffices. This will result in a circular scar around the areola that is often times very imperceptible. As the ptosis or droopiness worsens we may need to add a vertical scar to the circular scar that will extend down to the breast crease. In the most severe cases, a full mastopexy will be necessary to remove the excess skin. This type of breast lift will have a scar around the areola, one from the areola to the crease, and another one on the crease. All of the scars associated with mastopexy are at the level of the nipple and below, meaning that a woman can wear any clothing she likes without the scars being visible. Most patients will consider the scars a good trade off for the improvement in shape.

The incisions used to lift the breast allow us to simultaneously make the breast larger and to improve the shape. Implant size and shape selection will be critical in order to obtain the best cosmetic result. It is important to understand that breast skin thickness and elasticity will limit the extent to which we can ultimately enlarge the breast. It is important that patient understand that there are limits to the extent that breast can be enlarged.

Larger breasts can also lose their shape and require lifting. In such cases the lifting of the breast can be combined with removal of breast tissue. This surgery is referred to as a breast reduction. The scars will depend on the degree of descent of the breast tissue and will be similar to those used for a breast lift.

The Body

The breast surgery can be combined with body contouring. In cases when multiple childbirths have led to abdominal wall laxity or bulging, skin flaccidity, and stretch marks an abdominoplasty or tummy tuck will be necessary. An abdominoplasty will remove the flaccid skin and tighten the abdominal wall through a lower abdominal incision that is usually at the level of the bikini line. There is typically another scar around the umbilicus or belly button. Frequently liposuction of the waist can be added to further improve the abdominal contour.

On patients without abdominal laxity or skin flaccidity, liposuction may be enough to get rid of fatty deposits in the lower abdomen or flanks. Liposuction can also be used on the thighs and hips. Liposuction requires small scars and has a shorter recovery period.

The choices available to patients wanting a mommy makeover make it very important to seek consultation with a board certified plastic surgeon. The patient must be guided during the decision making process so that they have realistic expectations and they understand the nature and limitations of the procedure. The anatomy as well as the quality of the skin and tissue of each patient will ultimately determine the best combination of procedures.

Patient safety is a primary concern at Piedmont Plastic Surgery & Dermatology.  Each office has an accredited operating room and maintains the highest standards of care.  The procedures performed at Piedmont Plastic Surgery & Dermatology are done by plastic surgeons certified by the American Board of Plastic Surgery who have been well trained to do what they do.  The patient needs to be aware of the fact that many non-plastic surgeons, who have little to no training, are doing cosmetic procedures. You need to go to a qualified physician who has the proper training and expertise.  Additionally, you should be sure that your physician has hospital privileges and the experience to handle any complications, should they arise.

If you are considering a plastic surgical procedure, the surgeons at Piedmont Plastic Surgery & Dermatology can guide you and determine which procedure is best suited to meet your goals.