“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 make 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. To my knowledge, only one study has attempted to scientifically answer the question. In a small series, Dr. Brian Rinker, a University of Kentucky faculty member, determined that breast feeding was not associated with more breast drooping. Additional research is needed on this topic. Regardless, pregnancy itself leads to significant changes in the breast. The glandular tissue enlarges, stretching the skin out. When the glandular tissue shrinks down, this process alone can lead to sagging. Further, the glandular tissue will frequently decrease relative to the pre-pregnancy state leading to additional volume loss. The end result can be a droopy, deflated, breast.
Changes to the abdomen itself 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 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, and augmentation procedures with placement of an implant are used to change breast volume. 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 remaining to be repositioned and molded into a desirable shape. How do you decide which operations to have? The choices must be 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 taken into account.
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 sometimes 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 postoperative pain control. The foundation of the iTuck® procedure is repair of the 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.
David S. Kirn, M.D., F.A.C.S.
Dr. David Kirn is a Board Certified Plastic Surgeon who is devoted to advanced techniques in Cosmetic Surgery of the Face, Breast, and Body. In private practice since 1998, he is located in a state of the art facility which includes a full service skin care center. The practice is focused on personalized patient care and attention to detail. Where possible, Dr. Kirn utilizes minimally invasive procedures. The goal is to deliver quality clinical results while minimizing patient recovery time. Examples of this include a no-drain tummy tuck, armpit incision breast augmentation with gel or saline implants, fat grafting, and a short scar facelift (the MACS lift). In addition, Dr. Kirn and nurse-injector Carey Sanders, RN offer a full spectrum of non-surgical treatments such as Dysport®, Botox®, Restylane®, Juvederm®, Radiesse®, and laser.
© David S. Kirn, MD 2014