Dr. Behmand answers the question , “What is a mommy makeover?”
In recent years, the term “Mommy Makeover” has become a household name for cosmetic procedures to correct the effects pregnancy may have had on a women’s body, specifically the abdomen and breasts. That said, a Mommy makeover can entail any part of the body affected by pregnancy and age related changes of the body. Procedures most often associated with a Mommy Makeover are breast surgery such as augmentation or lift, a tummy tuck, and liposuction for contouring of the body. Other areas of the body are receiving more attention as well. These include the buttocks, through a brazillian buttlift, a lower bodylift or both. Ironically, a most affected part of the body due to pregnancy has only recently gained more widespread attention through labiaplasty and vaginal rejuvenation.
In most women, breasts become larger with both pregnancy and breast feeding. Each feeding of the baby is associated with first engorgement of the breast as milk fills the glands and milk ducts, and then a deflation of the breast as the baby is fed. This cycle of inflation/deflation eventually has an effect on most breasts, causing drooping of various degrees, and eventually loss of volume as the breast glands shrink permanently when breast feeding is terminated. A breastlift elevates the nipple into a more desirable position and tightens the breast skin envelope. If the breast has adequate volume and firmness, then no further work is needed. But, if the breast tissue has become soft and does not hold shape, or a larger breast is desired, then a breast implant is used. A breast implant is not exclusively meant to enlarge the breast. Aside from enlargement, a breast implant provides attractive shape and firmness which otherwise may escape an aging, deflated breast after breast feeding.
The obvious area of the body affected by pregnancy is the abdomen and the midsection. In many women, the abdomen may return to the pre-pregnancy form and tightness after the first, or even the second pregnancy. But, in most Moms, pregnancy causes laxity of the skin, perhaps some stretch marks and even separation of the abdominal muscles. This separation does not automatically result in the loss of the “six pack”, but it widens the distance between the two rectus abdominis muscle columns, resulting in a protruding abdomen. Many women describe this as the need to “suck in” their stomach while walking, or in a sitting position, especially when in a bathing suit or when wearing form fitting clothes. An abdominoplasty, also known as a tummy tuck, removes excess skin through an incision in the lower abdomen (taking out the C-section scar). Existing stretch marks may be removed up to the level of the belly button. The abdominal muscle separation is repaired and the incision is closed in a low position, at the level of the pubic hairline. To be specific, this procedure results in a low positioned hip to hip incision. Other procedures performed to address the mid-section area at the same time are liposuction for improving the contour of the flanks, back and even the inner and outer thighs.
These days the buttocks receive much more attention than years past. That is mostly due to the advancements in plastic surgery that allow for transfer of fat from one area of the body to another for improved volume, by way of fat grafting. The weight gain and loss associated with multiple pregnancies, and massive weight-loss operations, can result in sagging and deflation of the buttocks. If this sagging is severe, a lower bodylift may be considered. This procedure is also known as a circumferential tummy tuck for removing excess skin and lifting the buttocks. Following the lower bodylift, additional volume is introduced into the buttocks via fat injection, known as fat grafting, to improve shape and firmness of the buttocks. You may not require a lower body lift and correction of sagging may be achieved by fat injection alone.
The part of the body that is very likely to sustain injury and trauma with child birth is the vaginal canal and the labia. The vagina may not return to its original tightness after multiple pregnancies or tears which occur during the last stage of delivery. This can result in sexual dissatisfaction for both the patient and their partner. Of course, the physical vaginal changes are not the only reason that patients may have trouble with sex, but if the problem is identified as being due to a change in the tightness of the vaginal opening, then it can be addressed with vaginoplasty or vaginal rejuvenation. A much more common finding is the enlargement of the labia which may not be aesthetically ideal in appearance and functionally, they can become stretched, chaffed and be painful during vaginal intercourse. Enlarged labia, especially labia minora, are a common finding even in women who have never had a pregnancy. These patients may benefit from labiaplasty or reduction in the size of the labia.
Understanding which one, or combination, of procedures is right for you requires an in person consultation. To get the most out of your visit with a plastic surgeon, I recommend knowing in some order of priority the areas that are bothersome to you. This allows for a more focused discussion of what procedure, or procedures, may be most beneficial for you. Many of the above mentioned procedures may be performed during the same operation, shortening the recovery time that would be required when compared to the procedures being performed separately. Of course, the deciding factor from my stand point as the surgeon will be safety. So long as the desired procedures can be performed together safely, then the final decision will rest with you as to which procedures you wish to make up your Mommy Makeover. Factors you will consider will be recovery period, additional help required at home, and cost. Together, you and your plastic surgeon can decide what is right for you, and whether it is best to combine or divided the procedures.
-Ramin A. Behmand, MD