Encino, CA plastic surgeon George Sanders, MD is a fan of combination procedures and one of his practice’s most-popular includes the ever-storied surgery of the “Mommy Makeover.” While a customized approach is key, he typically focuses on the breasts and abdominal area to return fullness, tighten trouble spots, and create an overall more youthful appearance. Dr. Sanders recently shared with us everything that this surgery entails and what any woman considering one should know.
What exactly does a “Mommy Makeover” refer to?
“Mommy Makeover” is a term referring to a combination of body-contouring procedures, all performed at the same time, which lead to improvement in the physical changes resulting from pregnancy. Typically, a Mommy Makeover includes a combination of breast surgery and tummy surgery.
The breast surgery is usually an augmentation procedure with or without an uplift. Sometimes, only an uplift is needed. At other times, a breast reduction is done instead of the augmentation, depending on the size of the patient’s breasts and her goals.
The tummy surgery is generally a tummy tuck combined with liposuction of the hips, tummy and pubic area. Rarely, liposuction only is done. The tummy tuck is usually the standard type with rectus muscle plication to correct the muscle separation known as a diastasis, tightening of the upper and lower abdominal skin, along with repositioning of the belly button.
Sometimes, the amount of skin excess is such that the incision must be extended into the hip area to allow its removal, called an extended tummy tuck. At other times, the muscle does not need tightening in what we call a limited tummy tuck, allowing for a shorter operation and shorter recovery. Likewise, there are cases where the skin to be removed is only in the lower tummy, allowing for a shorter scar in the so-called mini-tuck.
Finally, some patients do not have significant skin laxity in the upper tummy, allowing for no scar around the belly button, but only a release of the belly button from the muscle and reattaching it an inch or two lower. We term this an ‘umbilical float’ because the belly button is released and floated down to its new position.
A type of tummy tuck that has gained popularity in recent years is the drainless type. Instead of requiring drains after surgery, the skin is lifted at the time of the tummy tuck, and sewn down to the muscle, minimizing fluid buildup after surgery, which eliminates the need for drains. This is certainly an option, but may sometimes predispose the patient to buildup of internal fluid that, although minimal in amount, can lead to internal scarring and lumpiness. Either pain pumps or anesthetic injections in surgery are used to minimize postoperative discomfort.
Who is the best candidate for one (and, likewise, who isn’t)?
To be a good candidate, your physical condition must be such that you can safely undergo what is usually a five-to-six-hour procedure and the recovery that follows. To qualify, you should also have the appropriate collection of body changes from pregnancy —oversized, deflated or drooping breasts, as well as laxity of the abdominal muscle and/or skin, plus excess fat about the abdomen/hip regions. The patient should also have realistic expectations of the results and be willing to take the proper amount of time off from normal activities after surgery so as to allow for healing.
A poor candidate would be a patient who will not stop smoking, has a BMI over 35, or someone who is in poor medical condition. Perhaps there is a strongly positive history of blood-clotting problems. A poor candidate would also have unrealistic expectations of their results and be unable to take the proper amount of time off from normal activities after surgery.
What kind of recovery is involved?
Many patients prefer to spend the first night after surgery at a recovery center. The subsequent recovery generally involves two weeks of minimal activity and rest. The patient is certainly not confined to bed but takes short walks and may spend time sitting in a chair or lounging about their home. Driving is generally permitted by two weeks and light exercise resumed at four weeks after surgery. Most patients can resume all forms of activity by six weeks. If no muscle tightening is required, all forms of activity are an option by four weeks.
Of course, it’s important to note that some patients take longer to progress in their activities than the guidelines listed above. Almost always by two weeks, most patients look great and can dress accordingly.
Are there “modified” versions of Mommy Makeovers that might not involve as many surgeries?
As listed above, a Mommy Makeover generally involves breast and tummy surgery. The exact type of each really depends on the patient’s needs. There is no one set formula for everyone—all of the procedures, however, can be done in one operation.
