For Reno, NV plastic surgeon Tiffany D. McCormack, MD the storied procedure of the Mommy Makeover is one of the most-performed surgeries at her practice. Even though it’s one she does often, she stresses that no two surgeries are alike, and every candidate’s treatment is completely customized, comprehensive and one-of-a-kind from beginning to end.
What makes the best candidate?
“A good candidate is, ideally, someone at or very close to their goal weight after pregnancy, someone who does not plan to have any more children and someone who is in relatively good health without untreated medical conditions. We want someone who’s physically healthy enough to go through the surgery, as well as mentally and emotionally in a good place.
Last but not least, make sure that you have a system set up to help you through the recovery, because it’s literally impossible to recover from a big Mommy Makeover surgery and take care of others (especially kids) at the same time. Some patients will wait until their kids are a little bit older and other people just have really good support systems around them to help them through that time.”
What does recovery typically look like?
“I tell patients that the first few weeks are when you’re at the highest risk for bleeding. That’s your real downtime. During the first two weeks, I tell them not to lift anything heavier than a gallon of milk, don’t do anything that gets your heart rate or blood pressure up, don’t do anything that strains you.
After two weeks, I typically say you can start to resume your normal activities of daily living—but it’s still nothing strenuous. Then, typically around six weeks, they can start to push themselves with exercise or more strenuous work. If they have a desk job, and they had a tummy tuck, I’ll usually recommend about two weeks off of work. If it is just breast surgery, I will recommend about one week off from work. Again, it depends on the nature of the job. If it’s a more strenuous job, then we will extend that time.”
Do most Mommy Makeovers always involve a tummy tuck and some kind of breast procedure?
“Yes, that’s the most common combination. We’ll see some kind of breast work and a tummy tuck, and then the tummy tuck may or may not involve liposuction. The breast work can be really varied. Sometimes, it’s a revision because they already had implants and then the pregnancy can make things look distorted, or they need a breast reduction, or they need a lift or a lift with an implant.
Is there anything patients are surprised about regarding the process from beginning to end?
“Yes, there are a couple things. The great thing about tummy tucks, as opposed to liposuction, is that you’re able to deal with the muscle, the skin, the fat, the fascia. Whereas, with liposuction, you’re just dealing with fat. I’ll often have patients come in—maybe they’ve had a couple kids, their muscles are spread apart, and they have stretchmarks that indicate a loss of elasticity in that area—and ask, ‘Can I just have liposuction?’
We have a full discussion about how liposuction will take away any fat if they have that, but it’s not going to address the skin and the muscle, and it’s just not going to give them the results that they want.
Similarly, with a breast lift, women will say, ‘I would just like implants.’ If they have ptosis or significant drooping of the breasts then I tell them implants just make what you have bigger. So, if you like where your breasts are sitting and you like the shape of your breast, putting an implant in will just augment that. If you don’t like those things, then we need to do a lift and reshape them or you’re just going to have a bigger version of the saggy shape that you have now.
With respect to recovery, patients will tell me they have a friend or a relative who had a tummy tuck, and it was the worst pain of her life. We’ve done a lot in my practice to change that. We use EXPAREL, which is a long-acting local anesthetic that lasts for about three days, so we really can numb that area up, including the muscle repair and the incision. We also use the multimodal pain medication approach, so many patients do not require opioids which contribute to nausea, dizziness and constipation. This way, the pain is better controlled, and the entire post-operative experience is improved—it’s completely changed the game.”