Mommy makeover

Mommy makeover

Mommy Makeover is a term used by plastic surgeons to describe a certain combination of procedures done at the same time. The purpose of these specific procedures is to restore a woman’s body shape and dimensions to what she enjoyed before the impact of the physical changes caused by pregnancy and breastfeeding. Combining these procedures is something that has been practiced for many years, and the technology is not new, but the standard techniques have been refined so that they can be performed during a single operation. There have been significant improvements in anesthesia, the reduction of blood loss, and in the prevention of major complications, such as blood clots leading to pulmonary embolism (blood clots that migrate to and lodge in the lungs).[1][2][3] The Mommy Makeover combination usually encompasses a breast augmentation, a breast lift or sometimes both procedures. In some cases, it may be a breast reduction. Additional to the breast surgery is a full abdominoplasty (tummy tuck) and liposuction for sculpting the figure. Mommy Makeover procedures are customized to the needs of the individual woman patient. The following link shows flow charts with a separate category for each part of the Mommy Makeover procedure; they can be used to assist a woman in exploring the different options available for her physical situation.


This is the process a patient can do to determine whether they are looking to have breast augmentation, tummy tuck and/or flank (waist) option procedures

Contents

Procedures

Breast Augmentation

It is common for a woman’s breasts to change shape and lose volume as a result of pregnancy and breast feeding. Breast augmentation is one of the most common procedures performed by plastic surgeons in the United States today, and either saline or silicone implants will restore fullness to the breasts. Breast enhancement is the simplest breast procedure for a Mommy Makeover due to the small incision and minimal recovery time. Refer to the flow chart to determine if breast augmentation is the best solution.[4][5][6][7]

Breast Lift

A breast lift (mastopexy) moves the breast higher on the chest wall by removing excess skin and tightening the surrounding tissue. The nipple can be repositioned as well. Depending on the patient’s preference for breast shape, there are three popular types of lifts.

  1. inverted T incision
  2. Short Scar or lollipop incision
  3. Peri-areolar incision, although this approach usually requires a breast implant, as it can have a flattening effect.

A breast lift is indicated when the nipples have moved into a lower location, and may even be pointing downward, rather than in a forward position. The type of lift that is chosen is dependent on the distance the nipple-areolar complex needs to be elevated and the amount of loose skin that is present. The purpose of a breast lift is to give the breasts a more youthful configuration.[8]

Preoperative view: a 32-year-old woman after having borne two children presents the condition for a mommy makeover with breast lift, tummy tuck and liposuction, to regain her pre-pregnancy body.
Postoperative view: A woman who underwent breast lift, abdominoplasty, tummy tuck and liposuction to the flanks.

Breast Augmentation with a Lift

In order to reclaim or add fullness to their breasts, some women will opt for breast augmentation to be done in addition to a breast lift. The impact of pregnancy and breastfeeding on the breasts often results in decreased breast volume. A breast lift alone may not achieve the volume a women desires and this is when breast implants provide the best solution. Breast implants can be added to any of the above breast lift techniques. The outcome will be elevated youthful breasts with breast volume individually adjusted for each woman.[9]

Mommy Makeover Patient #2 pre-op photo
Mommy Makeover Patient #2 6 month post-operative photo. This patient received a peri-areola breast lift with augmentation, abdominoplasty,tummy tuck and liposuction of the flanks

Breast Reduction

A woman with very large breasts prior to her pregnancy may find her breasts have retained their size, but have a less attractive, more elongated shape after pregnancy. Many of these women choose to have a breast reduction with their Mommy Makeover. For these women, a breast reduction will create breasts that are smaller, roundly shaped, and lifted. In some cases, the breast reduction portion of the Mommy Makeover may be covered by health insurance.[10][11][12][13][14][15][16]

Mommy Makeover Patient #5 post-op photo. This patient underwent an abdominoplasty, tummy tuck, breast reduction and liposuction of the flanks
Mommy Makeover Patient #5 post-op photo. This patient underwent an abdominoplasty, tummy tuck, breast reduction and liposuction of the flanks

Abdominoplasty (Tummy Tuck)

The Tummy Tuck is the core procedure of the Mommy Makeover, as the appearance of the abdomen is usually the primary concern of the patient. Pregnancy expands the abdominal wall and irreversibly stretches out the skin. This results in a protruding abdomen with loose skin that is scarred with stretch marks and often a misshapen belly button. Multiple pregnancies and twin pregnancies only amplify these changes. If a c-section was performed, this can lead to further distortion of the abdomen. With time, some c-section scars will develop an over-hanging ledge of fatty skin and tissue. The Tummy Tuck procedure will create a new incision, revise any unsightly c-section scarring, tighten the internal abdominal wall, create a more attractive belly button, and eliminate any looseness of the abdominal skin. At least some of the stretch mark scars will be eliminated with the excision of excess skin that is part of the Tummy Tuck procedure.See the flow chart for the tummy tuck here [1] The result is dramatic and long lasting.[17][18][19][20][21][22][23][24][25][26][27][28][29][30]

Mommy Makeover Patient #4 pre-op photo of a 35 year old female with weight loss
Mommy Makeover Patient #4 6 month post-op photo of patient with significant weight loss. Patient underwent a breast lift and abdominalplasty, tummy tuck
Mommy Makeover Patient #3 pre-op photo of a 39 year old female requesting a mommy makeover
Mommy Makeover Patient #3 6 month post-op photo. Patient underwent a breast lift only, abdominalplasty,tummy tuck and liposuction of the flanks

Liposuction

Liposuction is performed in conjunction with the Tummy Tuck to accentuate the waist and add definition to the abdomen. This is a crucial part of any Mommy Makeover. A nicely contoured waist blends into the flattened abdomen in a natural way. Likewise, a narrowed waist complements the proportions created by the breast procedure. The result is a body which looks much like what the patient had prior to her pregnancy or pregnancies.[31][32][33][34][35][36][37]

Recovery

The patient will have difficulty standing up straight for about a week due to the skin being stretched and snugly sewn. As the patient is increasingly able to stand upright, the abdomen takes on a firm, contoured appearance. Bruising will be present for about two weeks, though swelling tends to persist a few weeks longer and is dependent on the amount of liposuction performed. Pain medication, and very often a pain pump, is provided by the surgeon for pain management. It can take up to six months before the final surgical outcome is completely evident.[38]

The Mommy Makeover constitutes one of the most difficult recoveries in the realm of cosmetic plastic surgery. Comprehensive pre-operative and post-operative education of the patient and her family are essential for a smooth and successful recovery. The early issues are pain control, early ambulation, and management of the dressings and drains. By the second week, the patient is fairly comfortable with walking, eating, and travel to the doctor’s office for appointments. With the third week will come the biggest advances towards the patient’s return to her normal activities. She will be able to drive, return to work, and perform most household tasks. Once six weeks of recovery have been completed, the patient can resume formal exercise, if desired.

Risks

As with all surgeries, there are risks involved. The risks include bleeding, infection, small issues with the incision or belly button, or the side effects of general anesthesia. The most feared complication is blood clots (thromboembolism) and the spreading of blood clots to the lungs (pulmonary embolus). This complication has caused death, and therefore, plastic surgeons take great care in preparing the patient for surgery and educating the patient and family. Not all patients are candidates for the procedures being performed in one surgical setting. Depending on the patient’s health and preferences, the procedures may be completed in two stages.[39][40][41][42][43][44][45][46][47][48][49][50][51][52]

Costs

Mommy Makeover costs vary greatly, depending on the geographical location of the patient and the varying combinations of the procedures performed. Generally speaking, the most basic Mommy Makeover procedure will cost about $18,000, with more complicated and extensive procedures ranging up to $30,000 and higher.

References

  1. ^ Benchmarking Outcomes in Plastic Surgery: National Complication Rates for Abdominoplasty and Breast Augmentation 'Outcomes Article] Alderman AK, Collins ED, Streu R, Grotting JC, Sulkin AL, Neligan P, , James C.; Sulkin, Amy L, Haeck PC, Gutowski KA. Plastic & Reconstructive Surgery. 124(6):2127-2133, December 2009. doi: 10.1097/PRS.0b013e3181bf8378
  2. ^ Is It Safe to Combine Abdominoplasty with Elective Breast Surgery? A Review of 151 Consecutive Cases Stevens, W Grant; Cohen, Robert; Vath, Steven D.; Stoker, David A.; Hirsch, Elliot M. Plastic & Reconstructive Surgery. 118(1):207-212, July 2006. doi: 10.1097/01.prs.0000220529.03298.42
  3. ^ Safe and Consistent Outcomes of Successfully Combining Breast Surgery and Abdominoplasty: An Update Original Research Article Aesthetic Surgery Journal, Volume 29, Issue 2, March–April 2009, Pages 129-134 W. Grant Stevens, Remus Repta, Salvatore J. Pacella, Marissa J. Tenenbaum, Robert Cohen, Steven D. Vath, David A. Stoker
  4. ^ Breast Augmentation Spear, Scott L.; Bulan, Erwin J.; Venturi, Mark L. Plastic & Reconstructive Surgery. 118(7S):188S-196S, December 2006. doi: 10.1097/01.PRS.0000135945.02642.8B
  5. ^ Advances in Breast Augmentation Rohrich, Rod J. Plastic & Reconstructive Surgery. 118(7S):1S-2S, December 2006. doi: 10.1097/01.prs.0000247292.96867.06
  6. ^ The Efficacy of Breast Augmentation: Breast Size Increase, Patient Satisfaction, and Psychological Effects Young, V. Leroy; Nemecek, Jane Riolo; Nemecek, Douglas A. Plastic & Reconstructive Surgery. 94(7):958-969, December 1994. The Efficacy of Breast Augmentation : the degree of breast enlargement produced by augmenta.
  7. ^ Dual Plane Breast Augmentation: Optimizing Implant-Soft-Tissue Relationships in a Wide Range of Breast Types Tebbetts, John B. Plastic & Reconstructive Surgery. 118(7S):81S-98S, December 2006
  8. ^ The Limited Scar Mastopexy: Current Concepts and Approaches to Correct Breast Ptosis Rohrich, Rod J.; Thornton, James F.; Jakubietz, Rafael G.; Jakubietz, Michael G.; Grünert, Jörg G. Plastic & Reconstructive Surgery. 114(6):1622-1630, November 2004
  9. ^ Breast Ptosis: To Augment, to Lift, or to Do Both? Don Parsa, Fereydoun; Parsa, Alan A. Plastic & Reconstructive Surgery. 117(6):2101-2102, May 2006. doi: 10.1097/01.prs.0000214741.56973.e8
  10. ^ Current Trends in Breast Reduction Hidalgo, David A.; Elliot, L. Franklyn; Palumbo, Steven; Casas, Laurie; Hammond, Dennis Plastic & Reconstructive Surgery. 104(3):806-815, September 1999.
  11. ^ Reduction Mammaplasty Is a Functional Operation, Improving Quality of Life in Symptomatic Women: A Prospective, Single-Center Breast Reduction Outcome Study Chao, Jerome D.; Memmel, Heidi C.; Redding, John F.; Egan, Linda; Odom, Linda C.; Casas, Laurie A. Plastic & Reconstructive Surgery. 110(7):1644-1652, December 2002.
  12. ^ Inferior Pedicle Breast Reduction Technique Robbins, Thomas H. Plastic & Reconstructive Surgery. 73(2):325, February 1984. INFERIOR PEDICLE BREAST REDUCTION TECHNIQUE.
  13. ^ Vertical Scar Reduction Mammaplasty: A 15-Year Experience Including a Review of 250 Consecutive Cases Lista, Frank; Ahmad, Jamil Plastic & Reconstructive Surgery. 117(7):2152-2165, June 2006. doi: 10.1097/01.prs.0000218173.16272.6c doi: 10.1097/01.prs.0000240810.52392.51
  14. ^ Evolution of the Vertical Reduction Mammaplasty Spear, Scott L.; Howard, Michael A. Plastic & Reconstructive Surgery. 112(3):855-869, September 1, 2003 doi: 10.1097/0
  15. ^ Efficacy and Safety of Venous Thromboembolism Prophylaxis in Highest Risk Plastic Surgery Patients Seruya, Mitchel; Venturi, Mark L.; Iorio, Matthew L.; Davison, Steven P. Plastic & Reconstructive Surgery. 122(6):1701-1708, December 2008. doi: 10.1097/PRS.0b013e31818dbffd 1.prs.0000210677.44052.3f
  16. ^ Breast Reduction: Modified "Lejour Technique" in 500 Large Breasts Hofmann, Albert K.; Wuestner-Hofmann, Margot C.; Bassetto, Franco; Scarpa, Carlotta; Mazzoleni, Francesco Plastic & Reconstructive Surgery. 120(5):1095-1104, October 2007. doi: 10.1097/01.prs.0000279150.85155.1e
  17. ^ Abdominoplasty and Abdominal Contour Surgery: A National Plastic Surgery Survey Matarasso, Alan; Swift, Richard W.; Rankin, Marlene Plastic & Reconstructive Surgery. 117(6):1797-1808, May 2006.
  18. ^ Abdominoplasty and Abdominal Contour Surgery: A National Plastic Surgery Survey Swift, Richard W.; Matarasso, Alan; Rankin, Marlene Plastic & Reconstructive Surgery. 119(1):426-427, January 2007. doi: 10.1097/01.prs.0000245333.12259.87
  19. ^ Ultrasound-Assisted Abdominoplasty: Combining Modalities in a Safe and Effective Technique Abramson, David L. Plastic & Reconstructive Surgery. 112(3):898-902, September 1, 2003
  20. ^ Discussion: Painless Abdominoplasty: The Efficacy of Combined Intercostal and Pararectus Blocks in Reducing Postoperative Pain and Recovery Time Mustoe, Thomas A.; Fang, Robert C. Plastic & Reconstructive Surgery. 126(5):1733-1734, November 2010. doi: 10.1097/PRS.0b013e3181efff72
  21. ^ The Use of a Pain Pump for Optimal Postoperative Pain Management Pu, Lee L. Q.; Plastic Surgery Educational Foundation DATA Committee Plastic & Reconstructive Surgery. 117(6):2066-2069, May 2006.
  22. ^ . Liposuction Abdominoplasty: An Evolving Concept; Daniel Brauman, M.D Matarasso, Alan Plastic & Reconstructive Surgery. 112(1):299-301, July 2003
  23. ^ Liposuction as an Adjunct to a Full Abdominoplasty Revisited Matarasso, Alan Plastic & Reconstructive Surgery. 106(5):1197-1202, October 2000
  24. ^ Abdominoplasty: A Comparison of Outpatient and Inpatient Procedures Shows That It Is a Safe and Effective Procedure for Outpatients in an Office-Based Surgery Clinic Spiegelman, Jamie I.; Levine, Ronald H. Plastic & Reconstructive Surgery. 118(2):517-522, August 2006. doi: 10.1097/01.prs.0000227630.88566.74
  25. ^ Abdominoplasty, An Issue of Clinics in Plastic Surgery:August 2010
  26. ^ Full abdominoplasty with circumferential lipoplasty Original Research Article Aesthetic Surgery Journal, Volume 27, Issue 5, September–October 2007, Pages 493-500 Cárdenas-Camarena Lázaro, Laguna-Barraza Victor
  27. ^ Improving abdominoplasty results: Reconstruction of the linea alba sulcus by direct fat excision Original Research Article Aesthetic Surgery Journal, Volume 26, Issue 6, November–December 2006, Pages 682-686 Steve Laverson
  28. ^ Safe and Consistent Outcomes of Successfully Combining Breast Surgery and Abdominoplasty: An Update Original Research Article Aesthetic Surgery Journal, Volume 29, Issue 2, March–April 2009, Pages 129-134 W. Grant Stevens, Remus Repta, Salvatore J. Pacella, Marissa J. Tenenbaum, Robert Cohen, Steven D. Vath, David A. Stoker
  29. ^ Issues in abdominoplasty Original Research Article Aesthetic Surgery Journal, Volume 20, Issue 5, September 2000, Page A1 Armand A. Lucas, Joseph P. Hunstad, Renato Saltz, Luiz S. Toledo
  30. ^ . Awareness and avoidance of abdominoplasty complications Aesthetic Surgery Journal, Volume 17, Issue 4, July–August 1997, Page 256 Alan Matarasso
  31. ^ Liposuction as an Adjunct to a Full Abdominoplasty Revisited Matarasso, Alan Plastic & Reconstructive Surgery. 106(5):1197-1202, October 2000.
  32. ^ Liposuction as an Adjunct to a Full Abdominoplasty Revisited by Alan Matarasso, M.D Shestak, Kenneth C.Plastic & Reconstructive Surgery. 106(5):1205, October 2000
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  35. ^ . Evidence-Based Patient Safety Advisory: Liposuction Haeck, Phillip C.; Swanson, Jennifer A.; Gutowski, Karol A.; Basu, C Bob; Wandel, Amy G.; Damitz, Lynn A.; Reisman, Neal R.; Baker, Stephen B.; the ASPS Patient Safety Committee Plastic & Reconstructive Surgery. 124(4S):28S-44S, October 2009.doi: 10.1097/PRS.0b013e3
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  37. ^ Liposuction of the Flanks and Abdomen during Cosmetic Abdominoplasty: Safe or Sorry? Neaman, Keith C.; Armstrong, Shannon D.; Baca, Marissa; Renucci, John D.; VanderWoude, Douglas L. Plastic & Reconstructive Surgery. 126():71, October 2010. doi: 10.1097/01.prs.0000388792.69619.78
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  39. ^ . Procedural Risk for Venous Thromboembolism in Abdominal Contouring Surgery: A Systematic Review of the Literature Hatef, Daniel A.; Trussler, Andrew P.; Kenkel, Jeffrey M. Plastic & Reconstructive Surgery. 125(1):352-362, January 2010. doi: 10.1097/PRS.0b013e3181c2a3b4
  40. ^ Thromboembolic Risk Assessment and the Efficacy of Enoxaparin Prophylaxis in Excisional Body Contouring Surgery Hatef, Daniel A.; Kenkel, Jeffrey M.; Nguyen, Marilyn Q.; Farkas, Jordan P.; Abtahi, Fatemeh; Rohrich, Rod J.; Brown, Spencer A. Plastic & Reconstructive Surgery. 122(1):269-279, July 2008. doi: 10.1097/PRS.0b013e3181773d4a
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  44. ^ Benchmarking Outcomes in Plastic Surgery: National Complication Rates for Abdominoplasty and Breast Augmentation 'Outcomes Article] Alderman, Amy K.; Collins, E Dale; Streu, Rachel; Grotting, James C.; Sulkin, Amy L.; Neligan, Peter; Haeck, Phillip C.; Gutowski, Karol A. Plastic & Reconstructive Surgery. 124(6):2127-2133, December 2009. doi: 10.1097/PRS.0b013e3181bf8378
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  46. ^ . Abdominoplasty combined with additional surgery: A safety issue Original Research Article Aesthetic Surgery Journal, Volume 26, Issue 4, July–August 2006, Pages 413-416 Sean Simon, Seth R. Thaller, Nirmal Nathan
  47. ^ Does lipoplasty really add morbidity to abdominoplasty? Revisiting the controversy with a series of 406 cases Original Research Article Aesthetic Surgery Journal, Volume 25, Issue 4, July–August 2005, Pages 353-358 W. Grant Stevens, Robert Cohen, Steven D. Vath, David A. Stoker, Elliot M. Hirsch
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  49. ^ Continuing medical education article—patient safety: The need for venous thromboembolism (VTE) prophylaxis in plastic surgery Original Research Article Aesthetic Surgery Journal, Volume 26, Issue 2, March–April 2006, Pages 157-175 V. Leroy Young, Marla E. Watson
  50. ^ Thromboembolism in High-Risk Aesthetic Surgery: Experience With 17 Patients in a Review of 3871 Consecutive Cases Original Research Article Aesthetic Surgery Journal, Volume 28, Issue 6, November–December 2008, Pages 648-655 Christopher K. Patronella, Amado Ruiz-Razura, Germán Newall, Henry A. Mentz, Monica L. Arango, Tiravat Assavapokee, Jana L. Siarski
  51. ^ Prevention of Venous Thromboembolism in the Plastic Surgery Patient: Current Guidelines and Recommendations Original Research Article Aesthetic Surgery Journal, Volume 29, Issue 5, September–October 2009, Pages 421-428 Mark L. Venturi, Steven P. Davison, Joseph A. Caprini
  52. ^ Prevention of perioperative hypothermia in plastic surgery Original Research Article Aesthetic Surgery Journal, Volume 26, Issue 5, September–October 2006, Pages 551-571 V. Leroy Young, Marla E. Watson

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