A mommy makeover usually consists of a customized procedure for the abdomen and a customized procedure for the breasts. Women gain weight during pregnancy, and as your pregnancy progresses and your baby grows, you have stretching of the abdominal muscles which can lead to weakness. You also have stretching of the overlying skin which can lead to excess skin or stretch marks. Some patients also have localized fat deposits. You want to be at a stable weight after pregnancy before you have any mommy makeover procedures done.You also want to make sure that you are not breastfeeding if you are planning on having a breast procedure. If you are planning a future pregnancy, you may want to wait until you are finished having children before you have your mommy makeover.
If you are one of the lucky ones and only have localized fat deposits, and no excess kin or stretch marks, you may only need liposuction of the abdomen, flanks, hips, back, etc. If you have excess skin of the abdomen, a mini or a full abdominoplasty may be needed.
Abdominoplasty is a surgical procedure to remove excess skin and fatty tissue from the middle and lower abdomen and to tighten the muscles of the abdominal wall. Abdominoplasty is not a surgical treatment for being overweight. Overweight individuals who intend to lose weight should postpone all forms of body contouring surgery until they have reached a stable weight for at least 6 months.
There are different variations of abdominoplasty that can be performed. One type utilizes a short incision like a C-section incision of the lower abdomen, the muscles of the lower abdomen are tightened, and some liposuction for contouring is done. This is a mini tuck, and is good for patients with minimal excess skin of the lower abdomen and laxity of the muscles of the lower abdomen. A traditional tummy tuck will take out the excess skin of the entire lower abdomen by removing the excess skin from the belly button down. This requires a larger incision that usually runs hip to hip. The belly button is brought out through a new hole, and the muscles of the upper and lower abdomen are tightened along with some liposuction as well. A traditional tummy tuck is good for patients who have excess skin of the upper and lower abdomen with laxity of the upper and lower abdominal wall. There is also an abdominoplasty that is done as part of a circumferential lower body lift. This is done in patients who have lost a significant amount of weight and have laxity of the skin of the upper and lower abdomen, laxity of the muscles of the upper/lower abdomen, and have excess skin of the flanks, abdomen, and back.
A circumferential lower body lift takes out excess from the belly button down of the abdomen,excess skin of the flanks, and back. We would also tighten the muscles of the upper and lower abdomen, and bring the belly button out through a new hole. The skin and tissue of the back can either be removed, or used to enhance the buttock area. There are variations and different types of abdominoplasty that can be done.
For the breasts, you may need only a breast augmentation if you have just lost volume and upper pole fullness after child birth or breast feeding. If you have droopiness to your breasts after pregnancy, you may need a breast lift (mastopexy). No implants are used when doing a mastopexy alone. If you have droopiness and lost volume you may need an augmentation/mastopexy where you get a lift and an implant. You may need a breast reduction if having children has left you with larger breasts than desired. The type of incisions will vary depending on the type of procedure needed.
What procedures you need for your mommy makeover will determine if it can be done as one surgery, or needs to be staged as a second surgery. Although we all want to have everything done at once with one recovery, depending on what your needs are, Dr. Lovelace may determine that it is safer or in your best interest to split those surgeries up. Again, Dr. Lovelace will perform a personal consultation with you to determine which procedure or combination of procedures is right for you.
How much pain will I have?
Moderate to severe
How much will it cost?
A price quote detailing the fees for the facility, anesthesia, any postoperative garments, and surgeon will be given at the consultation. Prices will vary depending on the time that is needed to do the procedure, and the complexity of the procedure. Dr. Lovelace will perform a personal consultation to determine what the right procedure is for you.
How much hospital/surgery center time will I have?
Surgery will be approximately 2-6 hours as determined on a case by case basis.Typically this is done as an outpatient procedure, but an overnight stay may be necessary and will be determined by the surgeon.
What is the recovery?
Sutures that are placed are usually dissolvable and will not need to be removed.You may have drains that will stay in place for 1-2 weeks depending on what procedures are needed. These drains help prevent hematomas and seromas. You will be placed in a compression garment after your surgery, and told to wear this at all times for 8 weeks, and then only at night as long as tolerated. You will be expected to start walking immediately after surgery to help reduce the risk of blood clots. On average patients return to light duty work a week or two after surgery. You will be able to return to non-strenuous activity approximately 2 weeks after surgery. Approximately 8 weeks after surgery, strenuous activity will be allowed without restrictions. Scars will flatten and fade between 3 months and 2 years after surgery.
What medications should I take or avoid with my surgery?
You should not take any blood thinners or anti-inflammatory medications for a week before your procedure, and you should hold all over the counter supplements a week before surgery. This will help reduce the risk of bleeding intraoperatively, and help reduce the risk of postoperative hematoma (collection of blood). If blood thinners are prescribed for you by your cardiologist or primary care physician, you should get clearance from them to hold these medications before they are discontinued. You should hold all hormones 6 weeks before surgery. Birth control pills should be held 6 weeks before surgery as well. Of course you should make sure to use alternative forms of birth control during and after this time. Hormones and birth control pills put you at a higher risk of blood clots. These clots can go to your lungs and cause serious illness or even death. We call this a pulmonary embolus.Steroids should be weaned off at least a month before your surgery, and this weaning process should be set up and cleared by your prescribing physician. Dr. Lovelace and the staff will go through your list of medication, and let you know what exactly you need to do with those medications reoperatively. Make sure that you bring all of your medications with you to your consultation. You will usually be given your prescriptions for your postoperative medication on your preoperative visit so that they can be filled and at your house when you get home from surgery.
Will I need clearances from any other physicians?
Depending on your age and medical issues, Dr. Lovelace and her staff will set you up with your primary care physician, cardiologist, etc. for clearance prior to your surgery. At that time any necessary labs, EKGs, mammograms, or chest x-rays will be done. If any hernias are suspected, she may want to get a CT scan preoperatively as well.